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ENC2016-00226
19 , TECHCON Pruneyqrd 5 BioTreatment Soil Mix Submittal 4 Pa es Section Tifle BioTreatment BioTreatment: TMT Enterprises 9 I 0 1�MUM COBMUIONS S OMD� CTMars a + meaty das gnnesal contara:an.a g� s � " a f-W.;=opt o+ flea paoicc;,atad Vir6 aal �7Rh Utz WomiaRan given W ` tho cliaVact do tctsa( uaav :taatfVJ to srsgasi-c. of the Dmviago ftz4ecu,;Oa� Tito aysetrrnlca €sf rour 2u2b4 E t:sszusf f SAUL tzhi&�14, d : 1 and cam-clad a3 tho Job a,2;. ; N�= w-si d Ycyftarcs } r rs es�n freuSloal coc,cdL mUon W- fha T,,*ck V'ah *,w 0 CM 011hel 01 By c1Tt OF cAMP"Mu i MPT, OF PUBLIC WOM .BITUDSll°AL0- -- ---- i i { I ENTERPRISE S, INC. M gd IN BUSINESS SINCE 19.61 TO: Techcon Job. Ref: Pruneyard Bldg. S I Certificate of Compliance for Biotreatment Soil Mix I hereby certify that the Biotreatment Soil Mix, to be delivered to the project cited above from our company, meets the "Soil Specifications" criteria in sections 1-4 on pages L-1 to L,-4 of Attachment L of the San .Francisco Bay :Regional Water Quality Control Board's Municipal Regional Stormwater Permit (MRP) adopted on November 28, 2011, with the exception of the following minor deviations in the compost; bulk density, and particle size analysis. A copy of this Certificate of Compliance will be provided with the delivery of the soil mix. Our test results have been conducted within 120 days prior to the delivery date of the biotreatrnent soil mix to the project site. TA :ors Thank YouLJ PM ❑ . :N :r Clwck7mg ` a,tj tvr 7cs + 1 rcylho flog, Of 110 Signed: 4./@✓'F,.t QtWel illo c r r c ter Z c a rt r ] t a 3 it a :a4 on ;is ra in and Sje L5Lic"a cuc'l a ecc r test Name: Matt Moore GtC*LS�: ..aa3 '3:;•+`s?ki z it py - i 1a:1:,iC to CSYSr `S yQ Ll y.LiC.iS'y qXt,^. -:SCL'' Lea Uw work. Title: Operations Manager r' w.- - � /jj 5f j 4 Contact email address: matt(a,tfflft to P§es.net �'- ,&a Contact phone number: 408-432-9040 '1996 Oakland Road 0 San Jose,CA 95131 Phone:408-432-9040® Fax:.408-432-9429 I i i ENTERPRISES, INC. �.i,:'-# �°`��a`r��� �`nth � x '✓ a jh'rn'�q� �r�^ ra�.ar;�" w"ew'�'� . IN BUSINESS. SINCE 1961 To: Techcon Subject: BASMAA Submittal Package 1 There are currently two issues with Attachment C in the current submittal package, all relating to the compost used in the mix: t I 1. Bulk density is below the specified minimum. 2. The sieve data is not fully compliant. There is not, nor has there over been a compost in this.region that meets this specification We monitor every commercial compost operation within 100 miles, on a monthly basis. None are fully compliant at this time. We are using the best available compost in the region at this time. Please let me know if there are any further questions or concerns. Sincerely, r t) RIO P.tlt O 1011 aPAUDY ❑ I1QM C0711Ti G"f101YS Y¢'Oi"£".19 � +wf,sxleir..; fs a;ag f�,r co!;Somnex;ursa •xri4ls tivs daaiga eonas:pf I c3 14e prc:ect c-.i c_a-a-r1 0:,p:icmc,. ••yltL Yt+n :aifo—wCon eivera Eu Matt Moore the coatract dc'7'-e cran. Trry m'!`e%n ehuwaa ins cW)1ec; to the re ul;a- 1 1 Meat-. of t'"e naad Operations Manager 7110 eart!xaatos k, responGibl3 for d.;t-onviolm F'7:uck shall Ito�wnFirn d F crawl corr4w-tad a: they fob 41o, fabricotion, rroconson, aud 49uaa.:tttes of CmIDirVctlon, caosc'$aiatfnn of the -Nora -iwlth tl_Gt of all athe:: 4a.rsc, ar. ++J�roxf4fu�a: porfo=,mea rfi4 vv o ask. / ,S BY- C C 1996 Oakland Road 3 San Jose,CA 95131 i Phone:408-432-9040 4 Fax:408-432-9429 I . I 1 i l AttachmentA Supplier Analysis of Biotreatment Soil Mix The table below shall be completed by the Biotreatment Soil.Mix Supplier. Date: Apri15,2018 Name of Person Filling Out This Form: I Matt Moore .(All lab tests must be done within the last 120 days) i Title: Signature: Operations Manager I i�d2,2 Phone: Email: 408-432-9040 matt@tmtenterprises.net Company Name: City: TMT Enterprises, Inc. San Jo!�,..CA (Street Address: zip: I 1996 Oakland Road a� �i 3 �i � �, •._..j a . UAFF �1,jXj0jtD 0T. ,- ! certifythat the provided Biotreatment Soil Mix meets t s' `�� `�� Y`rl c°ram '"� �Va coneapf P �i}S�xs,�3f��; � 1 w ao,al com t rsn. a ,nodo given In requirements of Attachment L of the MRP. �> �� oaal � y, , Q�r� i ter*,< ;� t ter" AQ r Describe the e ui ment All materials are layered on �'clTr�afis'phdlfp�adbtJoict lalatld � i# , �: q P ofieciatal stifedder/bl"ende ea r t a front end loader, then feOffi and methods used to mix for a final homogenous blend. the compost and sand components of the CITY OF C:{Ij'8rT Biotreatment Soil Mix. i r.)'"PT or Pua m TLL "t;T,a�3'Al�,Z ar ��a a Material Standard Percent(by volume) Actual Mix% Pass Fail / Sand 60%-70% 60 ® ❑ compost 30%-40% 40 ® ❑ - P �. . . ® Yes (Pass) Does the soil mix have a permeability of at least 5 inches per hour?t ❑ No (Fail) ! i ®7— Yes (Pass) 1 Will the soil mix support vigorous plant growth? ❑ No (Fail) 'Soil mix permeability testing is only required for alternative biotreatment soil mixes. Soil permeability tests must be conducted on a minimum of two samples using constant head permeability in accordance with ASTM D2434 with a 6-inch mold and vacuum saturation. Attachment A j Page 1 of 1 1 3/31/2014 l I t Attachment B Lab Analysis of Sand Component of Biotreatment Soil Mix The table below shall be completed by the laboratory conducting the Sand analysis. Name of Person Filling Out This Form: Signature: Kyle Bowen Title: Date: G MAKE CIFY.0 D AVY5Z AM 9f 97.UM QC Technician 5/9/18,� ' ' - ; 7101 tho de-Aga concapi Phone: Email: ai ftx pro?aci and (J"nwcf1 co:Yvpurwf, rAtm g; 8� jal (925)-785-7690 kbowenth _1 3 au!�`evi to tho rdqvj_-�- Company: City: TIzo =bu0o7 Is abcd1l I>a co"fi-7d Desilva Gates Aggregates Sun[ i Cori,-C°Qd Q- Lhn to`) site. fcthrlcaddaT� pr)rosao, and twbm," " I of =wutrurflon, cooTHh:,A4n71 LA 11-a vmrTr 'P�rn thm 0 "11 otlwr Street Address: Zip: ,s,oy4crrAuaxe of the woo-. - 6527 Calaveras Rd 94586 ny Y, Qualifications&relevant certifications(ASTM, CTM or approved equivalent certifications): AASHTO'..-, T M_ Q.T,MA & Is sand free of wood,waste, coating (such as clay,stone Yes (Pass) dust,carbonate,etc.), orahy other deleterious material? No (Fail) ir V MIN, Is all aggregate passing the No. 200 sieve non-plastic?Is (Pass) E] No (Fail) 4 -0, A9111? Particle size analysis shall be conducted in accordance with ASTM D 422 (Standard Test Method for Particle Size Analysis of Soils)or CTIVI 202.Other equivalent methods acceptable only if approved. J Sieve Size Standard Percent'Passing(%by weight) Testing Results Pass Fail 3/8 inch 100% 100 El El No. 4 90%-.100% 95 Fx� 1:1 No. 8 70%-100% 74 El El No. 16 40%-95% 50 0 El No.30 15%-70% 34 F1 El No.40 or 21 5%-55% [K] El 50 No. 100 0%-15% 10 El El No.200 0%_5% 3.5 ———TO Attachment B Page I of I 5/27/2016 Attachment 4 F Lab Analysis of Compost Component of Blotreatment Soil Mix The table below shall be completed by the laboratory conducting the compost analysis 0' „r....���3P»�:.�#.c*"'{ �+°�x��t*'�i&t.�:k't«a+n.�.;'"a",.m"�:n f..r�: p^a<,,,..il.'*x el�r.r_�i;....�""....:,�a',a.`°.a«�...s4 •?„.n,•,:`^t'',,<"�'.�.N..a, t e�..k.��o'�::ra?...._'. j Name of Person Filling Out This Form: Signature: Assaf Sadeh Title: Compost Analyst Date: 03/27/�B QaY W Q" Phone: 831-724-5422 6mails 19 . Pji@?:ontrollabs.com ❑ t ''itM- .13M P ltMAT c 4 &A7, €3 y "'ate i4mc al c'ougoi mi th &0 +3 ` u W-0,61 Company: Soil Control Lab City: arwafe ME VEAUTM UUTP UME n ii2ic=at€aa gi®asa in txt�?'ce:u'a-i €nWz'; .a; ,^. a sloven t whiazi to tho rya+ m- � 1 Street Address: 42 Hangar Way Zip: 9SQ76mrat,dzz vo a saxv l�fto, Lts Ia'IL-h clad ba mmwzaad 3 ea-<>'rw d 01 i0I. stto, is alp..ry U sun. t�r Iv�i a , I Qualifications&relevant certifications: STA21— ) �� � (STA,ASTM or approved equivalent certification) ,K°fysr Specification Standard Pass Organic Matter Content 62.8 % (by dry weight) f Carbon-to-Nitrogen Ratio 15:1 to 25:1 (C:N) 23 C:N ® ❑ Salinity <6.0 mm hos/cm 2.8 mm hos/cm PH 6.2-- 8.2 7.1 pH Bulk Density 500— 1100 dry Ibs/yd3 443 dry Ibs/yd3 [) i Moisture Content 30%-55%(of dry solids) 43.5 % © j Percent inert ingredients <1% �. (incl.plastic,glass,paper) (by weight or volume) <0.5 % EJ ❑ Provide the results of at Nast one of the following analyses to indicate compost stability: f Specification Standard Testing Results Pass Fail Oxygen Test <1.3 02/unit TS/hr 02/unit TS/hr El El Specific Oxygen Test <1.5 0,-/unit BVS/hr 02/unit BVS/hr 0 ❑ Respiration Test <8mg COZ-C/g OM/day 5.1 mgCO,-C/g OM/day Dewar test <20"C Temp_rise e. 'C Temp. rise e. El El Solvita®Index value >5 Index valuefi Index value ❑ d,> so3�!t r?}r�+}'+'u•a1-d""`�t� k c��nrt�'x""q^" n rot ,�',�'� °�.�try #'�i �"�`?. �+�tp *,`Saiw T p-'.eq l9 E ^ ,y�,� h � zt Attachment C Page 1 of 2 `f i cir' fl. fl TAM Ij'tea COMa&;;91 (� 13 RVIM riwDi f �a€�rJ � e:�.�Y r saarxx�eoativass:iaa�sc� �a $ t4za 9ca 2 csat�3 con rtal wmpumca with' in Mad"4Iv=.in a tsn d¢�ra� " iwa. d1�y�acd=chow a!v gumad tea.P f Provide the.results of at.Ieast one of-the following Y anal se ' _ tg W ,4? ir:w— is -Mora. .s ago A UiwM Specification Standard I e`in ett Wpig 3i Ea' r;Z�J Ratio of NH4":NO3-N <3 :.NO3-N v Ammonium <.500.ppm,dry basis 17,0 ppm,dry basis Seed,Germination >80Yo of control 98 r °off� pntr, l; , Carr i�; ` Plant Trials >80%of control 100 • %of control ® ❑ � ��� ► Solvita®Index value. =5 Index value, Index value ❑ ❑ Provide the analysis of the nutrient content of the compost,including.the'folldviing: Spedcation Standard Testirig,Results Pass 'Fall Boron(total,in ppm) <-80 ppm 56 ppm ® ❑ Nitrogen(N)(total%) >.0.9%preferred. 1.5 % " s� Phosphorus.(as P205)- [not specified] 0.6 % Potassium(as K20) [not specified] 0.91 % mot =x ., o � I Calcium(Ca) ]not specified] 2.7 /° Sodium(Na) [not specified] 0.16 % �E { Magnesium(Mg) fnotsp,ecified] 0.589 /° Sulfur(S) [not specifiedj 150 ppm. ` = 52 w...3�M Provide the results of at'least one of the follm4ing select pathogens: i Specification Standard Testing Results Pass Fail - i Salmonella <3 MPN/4 grams TS <3 MPN/4 grams TS ® ❑ Coliform Bacteria <10,000 MPN/gram MPN/gram ❑ ❑ I Does the.product meet US EPA,40CFR 503 regulations regarding'trace ® Yes(Pass) i contaminants metals(Lead Mercury,etc.)? ❑ No(Fail) ! "' $ 4';'$ isx, '" r¢n�4, a,?: -,t`. ;. s Particle size analysis shall be conducted in accordance with ASTM D 422(Standard Test'Methodfor Particle Size Analysis of Soils)-washing not required.Equivalent methods acceptable if approved. Sieve Size Standard Percent Passing(by weight) Testing Results(%) Pass -Fail 1 inch 99%-100% 100 ❑ !:inch :' 90%-100% 100 0 ❑ ((( X inch 40%-90% 96.5 ❑ No 200 1% 10% 2.6 0 ❑ ,,e . r,x.. .,..„?+,."5..,3.5.Jr.. x._w A'wfu. '_,t....: ..,r... .,.s�}r e:.w...,_�x s.. ax Attachment C Page 2 of 2 i f t I `s�� tatc�� � � �..,❑ �id;'�� ��e t� ,1 ❑ mrso a= Wkim e caioafty ts w2viou ral c ey Ces 9 a 4 elb 1s c2'rmd Vem comis�Icmeao vritk tk kdoswaf3� giaoa V" a d z" Any 40cdoa show 'b aublem W t - me CA Vaq DMWIEU5 s -atio . tys job 'so'Attach f'd iaaRs e� �.i:ia�� � :. � �...'0&eT I- Supplier Analysis of +Compos - of Bi®treatment Sol The table below,sholl be completed by the Compost Supplier pray c in (r n�'17 0�f .the mix,p1;elvcT4# - Name of Company: Date of Delivery: 1 Qualfft tions&relevant certifications; Date of the Compost Lab Analysis Report: (STA,ASTM or approved equivalent certifications} (Must be dated within 120 days prior to delivery) Name of Per on Filling Out This Form: Date: Signature: Street Adclress. 19 Email address: City: I Phone: Zip: 4 '• sh `�a C �y t�X 5� .` 1=#r`wil'1't K�,. ` ''R-*rik'�:�{ar`ny.,.r . . ..,fin.J'CKb'Ba"i.. .F NVMt'•:G c�a'$ 4 .4:.�, �n��ii�•..... '.C# N"�k t S' w,'R.... �''' �i .s sY:"�-f J Qs 1 Feedstock materials have been specified and include only the following:. (Pass) Landscape/yard trimmings,grass clippings,food scraps,or agricultural crop residues? [] No (Fail) i x¢+^{ �NyF. ,+.+ iilfli"x"'Y. . � + ,a'�.,�+✓anr3. r• Itf, <a 'emu 3*^ +:r- +, w i ?s.:< .,;a,Yst. ...,'E".�;iv�•r_.:+.�..c.y�.'S �.xt_'• .5e',+�h.x.��:an.a&z�,�r..kt-i:lam, �a�..sx. - I Compost has a dark brown color and a soil-like odor,does not exhibit a sour or putrid •(Pass) i smell,does not contain recognizable grass or leaves,and is not hot(1207)upon delivery or rewetting? ❑ No (Fail) T„s n u:�, k n*try ..§�. +,{.c.�+r=:.�&w dw. 'z"i"'�'�., ..ax.- �r�+s.,;...`a <sx�s; t t�?'�. �"• ��`"�"' The compost has gone through the process to further reduce pathogens(PFRP)? For (Pass) example,turned windrows must reach a minimum temperature of 55C for 15 days � Pass) 4 with at least 5 turnings during that period. ❑ No i I (Fail) I c C-;z.. r„,...': -•r-.+.,.+�s ..y, sy'a1` ,�.;ss*.veya at=+.tiaA+vw--c ar ^u r �..-. �..:3:c.��"�.�..G's:�ait'�e�l��i.,.."�w.`":�55,��.s:`z�'v.,S.�'ar��` ;'�.�'�;�.r�r�.��"+?5;-:`;'.i;4�;. .�` ..m.°4 tf ..a•s.` �:r^ ,+ "j l 3/3.I/2014 Attachment p Page 1 of 1 I 7 O •Uf1C11AR� CITY OF CAMPBELL Public Works Department June 4, 2019 Mr. Dean Rubinson CFEP Pruneyard, LLC. 111 Sutter St. Suite 800 San Francisco, CA 94612 Re: Permit#ENC2016-00226;The Pruneyard, Campbell, CA Dear Dean: Enclosed are your deposit refunds for The Pruneyard in Campbell. The refunds include the Construction Cash Deposit for$8,000.00 and the Monumentation Deposit for$10,000.00. The City of Campbell has made a final inspection of subject Public Works improvements and finds the work to be acceptable and in conformance with City standards. Accordingly, the City Engineer accepts the improvements. If you have any questions,please call me at (408) 866-2157 Sincerely, Syed Wahidi City Inspector Enc: Check#273636 1 70 North First Street Campbell, California 95008 TEL 408.866.2150 FAX 408.376.0958 TDD 408.866.2790 ... ........... ....................................... ............... .............................. ........... ............. ............................. ........... ....... .............. ............. CITY OF CAMPBELL VENDOR NO. 10013873, CHECK NO. 273636 Aecorrnt Priichase.:O'*t`dd'r' 101 2203 CRO52019 18,000.00 ENC2016-226 PRUNYARD > 10013873 CFEP PRUNEYARD LLC Gu CITY QW.CAMPBELL WE U CHECK DATE CHECK NO.S:FARGO SANK, N.A. 11-24 72-1-0 06/03/19 273636 70 NORTH FIRST STREET �2,O, ,MONTGOMERY STREET .'w .SAN FRANCISCO, CA 94104 <r .CAMPBELL;CALIFORNIA 95008 > 0 i AMOUNT $ ****18, 000 . 00* VOID AFTER 90 DAYS -n 0 > PAY THE SUM OF EIGHTEEN THOUSAND DOLLARS & ZERO CENTS 03 TO THE CFEP PRUNEYARD LLC ' -ORDER 111 SUTTER, SUITE 800 6F SAN FRANCISCO CA 94612 1: 1210002481: 4 12 113 S 54 1 So 09m.MMi ............................. ................................. .................................... ........................ ......................................... ............-............. ........... ............................. ................ ........................................ ............................. ....................................... ................................... ...................................... .................. *See Reverse Side For Easy Opening Instructions* CITY OF CAMPBELL 70 NORTH FIRST STREET CAMPBELL, CALIFORNIA 95008 i I CFEP PRUNEYARD LLC 111 SUTTER, SUITE 800 SAN FRANCISCO CA 94612 OF c4 y •UkCHAR�• CITY of CAMPBELL Public Works Department December 10, 2018 . Mr. Dean Rubinson CFEP Pruneyard, LLC. 111 Sutter St. Suite800 San Francisco, CA 94612 Re: Permit# ENC2016-00226;The Pruneyard., Campbell, CA Dear Dean: Enclosed'is your Plan Check Deposit refund in the amount of$3,656.59 for the above-mentioned project. Sincerely, z Epecialist mason 70 North First Street Campbell, California 95008-1436 TEL 408.866.2150 • FAX 408.376.0958 TDD 408.866.2790 **This document was electronically submitted to Santa Clara County for recording** RECORDING REQUESTED BY: 24178900 HMH Regina Alcomendras Santa Clara County-Clerk-Recorder 1570 Oakland Road 05/14/2019 02:14 PM San Jose,CA 95131 Titles: 1 Pages: 1 WHEN RECORDED,MAIL TO: Fees:$100.00 Tax: $$ City of Campbell City Clerk's Office Total: 100.00 70 North First Street Campbell,CA 95008 (For Recorder's Use Only) CERTIFICATION OF CORRECTION That certain Parcel Map,filed for record in the Office of the Santa Clara County Recorder in Book 904 of Maps,pages 9& 10, is hereby corrected in accordance with Chapter 3,Article 7,Sections 66469 through 66472.1 of the Subdivision Map Act as follows: The Legend on Sheet 2 is corrected to read as follows: ® 3/4" IRON.PIPE SET & TAGGED AS 8720",OFFSET 3' INTO PROPERTY On the date of the filing of the said map,the name of the fee owner of real property affected by such corrections was as follows: CFEP Pruneyard LLC. SURVEYOR'S STATEMENT This Certificate of Correction was prepared by or under the direction and control �p ,AND SG of the undersigned Registered Land Surveyor. G10,, 'QL A v Date: , 32S`� i O Traey rgetti, . 720 HMH 3655.10 No. 8720 (P 9�OF CAl1F���\P CITANGINEER Thi d ument has been roved by the City of Campbell. Date: Amy qlay,P.E.,)tity ngineer RCE 61922,Ex irati Date:9/30/2019 City of Campbell Department of Public Works 70 North First Street Campbell,CA 95008 SUBJEC'r: NIONUMEN'I'BOND RELEASE PARCEL iv(AP t TRACT MAP NO....hIU. 1?;UN .'f 1 v Recorded in Book .....212.1..........of Maps,at page(s)......1.::l.D................... Dear City Engineer: In conformance with the requirements of Section 66497 of the Subdivision Map Act,please be advised that the Engineer/Surveyor has been paid in full for setting the monuments within the above described subdivision. It is requested that Monument Bond Cash Deposit in the amount of...............................:.2 be released. Developer/Agent Q--7--)Y Date of signature of this document CERTIFICATE OF ENGINEER OR SURVEVOR l.......: ...... ...certify that all monuments as shown on the map of the above described subdivision are now set and that payment in full for this work has been received. SAND �, t310Rc�'PL�.t Civil Engineer e2nd Surveyor U O LS 97;o (af30/zo _ No. �720 � License number Expiration date * zI//X -- -- �@ Date of signature of this document �OF CALICO NOTE: Processine nd release cannot occur unless all of the nbove information is complete CITY OF CAMPBELL City Inspector Date Comments: Rev.09/2014 Refundable Deposit Check Request �. r � To: Finance Director Check Payable To: CFEP Pruneyard, LLC. Address- Line 1: 111 Sutter Ave.,#800 Line 2° City: San Francisco State: CA Zip: 94104 I Description: ENC2016-226 Pruneyard Account Number: 101.2203 Amount: $18,000.00 Account Number: 101.2203 Amount: Account Number: 101.540.7448 Amount: (Finance Dept only) Interest Earned (Finance Dept only) Total Payable: (Exact Amount) Purpose: Monumentation &Construction Cash Refunds Permit#: ENC2016-00226 Receipt#: 268035 Date: 2/8/2017 Receipt#: Date: Requested by: Title: City Inspector Date: / Syed 7ah' Approved by: ' V Title: Sr. Engineer Date: . 23 1 Roger Storz Date:5 Z3�Gf Todd Capurso PM Director Finance Dept Only: Verified by: Title: Accounting Clerk If Date: Approved by: Title: Accountant Date: Special Instructions For dandling Check Mall As Is: Mail in Attached Envelope: Interim C:hecK: Needed By: Return To: JoAnna Thomason Public Works (Name) (Department) CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT C�kEAR CIS POR FINAL :CTIONv AND AGCE8TrA,a ff ETTER Encroachment Permit#: ENC2016-00226 Name: The Pruneyard Property Address: 1875 S. Bascom Ave. Date of Final Inspection: On File: Bonds CD Cash Faithful Performance: $ Labor and Material: $ � s r�l!"UH -ash Deposit tube Meleased * ,0�00.00 Other overdue deposits to be released (Description): Processed by: 51as 1 Administrator Reviewed by: �nspector Reviewed by: Land Development Engineer J:VoAnnaT\Deposit refunds\CHECKLISTSTruneyard final.doc(Rev. 10/11) own rc Print Farm ENCROACHMENT PERMIT Permit NoIft .+ CITY OF CAMPBELL �°� j (for working Within the public X-Ref.File )EPT.OF PUBLIC W right f-way) Application Date' 70 North First Stree �7 L'I - Application Expiration Date Campbell,CA 95( WOtO a(J('(il)11$tta Q sued �l APN_ Ph. (408)866?d0c a ' Fx (408)376-0958 - Permit Expiration Date r n is hereby made fora Public Works Permit in accordance with Campbell Municipal Code,Section 11.04. (Application expires in six I APPLICATION-ApPl j is not issued.Application Fee is non-refundable.) (6) months if,the p' ,ri(ddress or Tract No.: 1875 South Bascom Avenue,Campbell,CA 95008 A. ;i Utility Trench Location: N/A B. Nature of work: Driveways and ADA ramps upgrade C. Attach four(4)copies of an engineered plan showing the location and extent of the work,and four(4)copies of the preliminary Engineer's --� Estimate of work.The plans shall show the relation of the proposed work to existing surface and underground improvements. When approved by the City Engineer,said plan becomes a paR of this permit. i D. All work shall conform to the City of Campbell Standard Specifications and Details for Public Works Construction;the General Permit Conditions listed on the reverse side;and the Special Provisions for this permit,listed below. Failure to abide by these conditions and provisions may result in job shutdown and/or forfeiture of Faithful Performance Sureties and cash deposits. (See General Permit Conditions 1 and 2.) E. The Contractor must have this permit andapproved plans aCthe site and must notify the Public Works Department at least two days before starting work. Notice must be given to Fublic Works at least 24 hours before restarting any work. i Name of Applicant: Dean Rubinson Telephone: 415-391-9800 t Address: 111 Sutter Street,CA 94104 E-Mail Address: Dean@ellispartners.com 124-HOUR EMERGENCY PHONE NUMBER: 415-373-7706 Is this work being done by the property owners at their own residence? YES NO 1 The Applicant/Permittee hereby agrees by affixing their signature to this permit to hold the City of Campbell,its officers,agents,and employees free,safe and harmless from any claim or demand for damages resulting from the work covered by this permit. i i The Applicant/Permittee hereby acknowledges that they have read and understand both the front and back of this permit,and they will inform their contractor(s) of the information. Applicant is advised that upon issuance of this permit, property owner, or property owner's successors, shall be responsible for any and all d /mages arising out of the conditio pyNate improvements in the public right-of-way. Accepted: �h S S/ f n �°A A (Applicant Permitt / (sign) Date / �ii L' ��4�1�/ ��l 9✓�1 �// �a �l�6 (Contractor) (Print Na Date SPECIAL PROVISIONS: - 1. Street shall not be open cut for underground installations. Minimum cuts may-be allowed for connections or exploration holes. Such cuts may be - specifically approved by the Inspector prior to cutting. 2. Pavement may be cut for underground installations and must be restored in accordance with the Standard Details Trench Restoration Method "A",unless otherwise approved by the Engineer. i 3. Work to be staked by a licensed Land Surveyor or Civil Engineer and two(2)copies of the cut sheets sent to the Public Works Department before starting work. _X-4. Per Section 4216 of the Government Code this permit is not valid for excavations until Underground Service Alert(USA)has been notified and the inquiry identification number has been entered hereon. USA Phone: 1-800-227-2600. USA TICKET NO. 5. Prior to any work,the property owner shall execute an Agreement for Private Improvements in the Public Right-of-Way,which shall be recorded. l 6. Public Notification Requirements: j 7. SEE PUBLIC WORKS FEE SCHEDULE FOR CURRENT FEES AMOUNT ` R,ECEIPj NO. j PERMIT APPLICATION FEE S L(n� PLAN CHECK DEPOSIT $ SECURITY FOR FAITHFUL PERFORMANCE/LABOR&MATERIALS $ 0 CONSTRUCTION CASH DEPOSIT $ CIO PLAN CHECK&INSPECTION FEE $ Z fudD.00 0 EMERGENCY PERMIT FEE $ APPROVED FOR ISSUANCE For City Engineer Date Permit Expires 12 Months After Date of Issuance Re% i -, _�.�---�- 1 ____�!- ��'- � l 1 1�_�� 1 Refundable Deposit Check Request - To: Finance Director \ Check Payable To: CFEP Pruneyard, LLC. _J Address- Line 1: 111 Sutter Ave.;#800 i Line 2: 1 i City: San Francisco State: CA Zip: 94104 8 Description: ENC2016-226 Pruneyard \ -- Account Number: 101.2203 Amount: $3,656.59 Account Number: 101.2203 Amount: Account Number: 101.640.7448 Amount: (Finance Dept only) Interest Earned (Finance Dept only) Total Payable: (Exact Amount) Purpose: Plan Check Deposit Refund Permit#: ENC2016-00226 Receipt#: 266686 Date: 11/7/2016 Receipt#: Date: t Requested by: Title: Asst. Engineer Date: ► WLq J, LI Doris Approved by: Title: Sr. Engineer Date: Roger torz Date: Finance Dept Only: Verified by: Title: Accounting Clerk II Date: Approved by: Title: Accountant Date: Special Instructions For Handling Check Mau As Is: Mail in Attac e: Inter) Needed By: Return To: JoAnne Thomason Public Works (Name) (Department) 11/29/2018 11:05AM Payment History For < EL Case#: ENC2016-00226 Recordetl T , e '. Fee ll2-,# ,': "1 Descri`t'on B Dde H[isto Ty g n Fees �Patd Date Paid Check# Receipt#_' Y . ry _ . _,. AF02 201611071557197560 PrmtAppFee-Major-Eng 403.00 403.00 1a/7/2016 266686 JT 0.00 Est>=10K PCDP 201611071557384920 Plan Check Deposit ^ -VOL50 3,656.59 1@14€/F.0106MMW eft-6AME& JT 0.00 GRA4 201612011436167760 Grdng&Drain Pin Rev>= 1,688.00 1,688.00 266977 JT 0.00 .5 Ac PCI1 201612011438354570 Non-Util Plan Ck/Insp< 600.00 600.00 266977 JT 0.00 $250K FMPM 201612011439049780 ParcMap Fee=<4 4,270.00 4,270.00 266977 JT 0.00 Lots+$87eachlot SDC 201702081405581030 Storm Drain Fee-All 300.00 300.00 2/8/2017 268035 JT 0.00 Others PCI1 201702081406385230 Non-Util Plan Ck/Insp< 27,400.00 27,400.00 2 JT 0.00 $250K CASH 2O1702081409252850 Construction Cash Deposit 00.013 8,000.00 RM/,20 -7 80952ft JT 0.00 MONU 201702081410049160 Mon.Sec.Dep100%ofCity's Js®€110.0� 10,000.00 /201 -5 JT 0.00 —Est. CASH 2O1702081410472860 Construction Cash Depos' S�000F00 45,00 0 2 /2,0�1�7� a6ft9-5mmW JT 0.00 ASH 2O1702081411122460 Construction D osit . 40,000. 0 2481R20i1� ^5 t'�a `C. S`S�`J—JT 0.00 fX4,C 8 aw5k, 50 .00 e&,t:O1IW7mb 2&8i135 �"�b' `SJT 0.00 FPSD 201702081412521270 Faithful Perf. Securi 00 00,000.00 2/8/2017 268033 JT 0.00 FPSR 201704040945235230 Faithful Perf. - -200,000.00 4/4/2017 261837 JT 0.00 Security/Refund PCI1 201707251147113810 Non-Util Plan Ck/Insp< 500.00 500.00 7/19/2017 270558 JT 0.00 $250K Total Fees:$191,817.59 Paid:$191.817.59 TOTAL REMAINING DUE: $0.00 Sew 0 J5 Page 1 of 1 CasePaymentHistory..rpt JoAnna Thomason OV-CAllt4 Office Specialist .� City of Campbell,Public Works 70 North First Street U r Campbell,CA 95008 o a Phone:(408)866-2150 y E-Mail:Joannat@cityofeampbell.com Ok�H ARO - - - -Transmittal I I To:Dean Rubinson, CFEP Pruneyard,LLC. Date: December 4,2018 Re: Return of Original Bonds for Pruneyard Project: Bond#PB00345100046 Please find enclosed your original Bonds for Faithful Performance and for Labor/Material in connection with our Pruneyard Project. The check for your Plan Check Deposit Refund is being processed and.will be sent to you as soon as 'it is ready. Sincerely, JoAnria Thom son Office Specialilt City of Campbell cc: Project File Philadelphia Indemnity Insurance Co. \iHonouliuli.cityhall.ci.campbell.ca.us.local\Prdfile_Data$yoannat\DesktopWy FormsUransmittals\Pruneyard bond retm.doc(Rev.03/08) CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT C�iGE�I"u0� EFU'ND ISO U''i�IENTp1`II+DN D1='P'OSIT Parcel Map book and page: 904, 9-10 Tract Number: Encroachment Permit #ENC2016-00226 Property Address: The Pruneyard Letter received from Surveyor (Name):.Tracy Giorgetti Dated: 12/5/18 Date of City Inspection: 5/2/19 By: Syed Wahidi On File: Bonds CD Cash 5,000.00 C&nstrunt':oIQ I Deposit Amount of Monumentation Deposit 0,000W.00% Processed by: Adminis ator Reviewed by: I l� Land Dl�veiopment trigineer Reviewed by: 1 h City Engineer JAJoAnnaT\Deposit refunds\CHECKLISTSWonumen tat ion Clearance.doc Ref undaL,.Iw Deposit Check -Requ__fi To: finance Director Checkf;Payable`To: CFEP Pruheyard, LLC." _.. Address'-Line 1: 1.11 Suffer Ave.,#800 . Line 2 , City: San Francisco ` State: CA Zip: 94104 Description: ENC2016-226 Pruneyard Account Number: ' 101.1263' Amount: $200,000.00, - Account-Number: :.1:01.2203 : Amount: Account Number: 101:540.7448 Amount: (Finance Dept-only) Interest'Earned' (Finance Dept only) Total'Payable:: (Exact Amount) Purpose: FPS Deposit exchanned for Bonds Permit`#: ENC201(i=00226 Receipt# " ' 268033 Date: 2/8/2017 " Receipt MI Pate:,` Re- uested.by. Title:qAsst Engineer, Date 3/21/201.7 Doris Quai Hoi Approved by: Title: Sr..Engneer- ., ;Date: Roger Storz - ; Date Z Todd Capurso P/W Directo_ r ` Finance Dept Oniy: Verified by _ . Title: Accounting Clerk 11, Date: . Approve.d.by: Title: _ . Accountant Date: ' S eci.al' Instructions .For: Handle Check Rnall AS:.IS: Malvin Attached-Envelope: In erin7 t: eCK Needed By: Return To: JOAnna•Thomason Public Works (Name) (Department),_ Other. Please return checkto,JoAnna = P s PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2016 TO: Finance PUBLIC WORKS FILE NO. ENC 2016-226 PROPERTY ADDRESS 1875 S Bascom Avenue(Pruneyard) Please collect&receipt for the following monies: .AGCT ITEM AMOUNT LAND.IDEVELOPMENT` f` Encroachent Permitpp Ica ion Fee Non-Utility Encroachment Permit Major?$10,000 $403.00 Minor Encroachment Permit<$1 o,000 $230.00 Initial R-1 Permit . N/C Subsequent R-1 Permits within Two Year Period $230.00 Inspection Fee Minimum Charge per Location $398.00 Street Tree Planting/Removal N/C 2203 $500 per Tree Planting Deposit Required) $500.00/tree 2203 Plan Check Deposit 2%of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 4722 Grading&Drainage Plan Review Single Family Lot $281.00 Site<10,000 s.f. $841.00 Site_10,000 s.f. <0.5 Acre $1,127.00 Site>_0.5 Acre $1,688.00 $ 1,688.00 4722 NPDES Review C3 Requirements) For projects not required to submit numeric sizing $163.00 For projects required to submit numeric sizing Impervious Area 10,000 S . Ft to 1 Acre $704.00 Impervious Area 1 Acre or more $918.00 $ 918.00 4722 For ro'ects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities $300 ea Plan Check&Inspection Fee(Non-Utility) 4722 En r. Est.<$250,000 14%of Engineers Estimate Q C7 4722 En r. Est.>_$250,000 and 5$500,000 $35,000+8%of Engineers:Estimate 4722 En r. Est. >$500,000 $55,000+7%of Engineers Estimate 2203 Emer_qencv Cash Deposit 4%of En r. Est.`($500 min/$10,000 Max) 2203 Faithful Performance Security FPS 100%of ENGR.EST.* 2203 Labor and Materials Security 100%of ENGR. EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 (Multi-Res:$2,385.00) All Other$2,650.00 4722 Parcel Ma 4 Lots or Less 4009.00+ 87/lot 4,270.00 4722 Final Tract Ma 5 or More Lots 4,871.0 + 118/lot 2203 Monumentation Security 100%of Ci 's Monumentation Estimate 4920 Parkland Dedication Fee 75%/25%o Due Upon Cart.of Occupancy) 4722 Lot Line Adjustment(Includes Certificate of Compliance) $1,893.00 4722 Vacation of Public Streets&Easements $2,530.00 4722 Certificate of Compliance $1,877.00 4722 Certificate of Correction $561.00 4722 Document Recording Fees $15.00/first page$3 ea.Additional 4722 Private Improvement in Public ROW $50.00 4722 Approved Plan Revision Fee $100/sheet 4722 AppeaI Filing Fee $200.00 4722 Notary Fee(per signature). $10.00 4722 Assessment Segregation or Reapportionment First Split $895.00 Each Additional Lot $281.00 511.7424 Postage MISCELLANEOUS, Other Please Specify) �f *Engineer's Estimate shall be as approvedby the City Engineer and shall include all items of work. TOTAL $ �/ 6 NAME OF APPLICANT AMP'- �l� (6 l/1 )Egg —26 NAME OF PAYOR C,R n- PHONE ADDRESS ' ( -j5` ZIP % Ll FOR RECEIVED.' X ' CITY CLERKAll e tvWo ONLY Date Receipt# 7 I JA�VDe lm Check Cmun 01-Spwfx Pq--AC,,Pq-mP,.gres.T.—A-1995(P—grd CITY OF CAMPBELL RECUR BY: CASHIER 0i000266,77 FAYOR: CFEF PRU14EYARD LLC. TODAY'S "DATE- 11,130116 l REGISTER VA' : 11f30E i6 TIME: C:O:i?O {DESSt C CRIFTIyO,/N r [ AMOUNT -226 ENaR & SUBDIV FILING F $1,680.00 OUST III.: I XOD ENGR & SUROIV FILING F $9is.00 CUST 111: 1.000 ENOR 8 SUBDIV FILING F �600.G0 OUST ID: 1.000 ENGR S SUBDIV FILING F $4,270.00 ---------------- TOTAL DUE: $71,476.00 TENDERED: $7,476.00 CHANGE: $.00 CHECK $3,206.00 REF NUN: 1512 CHECK $4,270.00 REF HUM: 1511 Encroachment Permit Final Sign Off Encroachment Permit,4 2c G--00 22C, Address: �' 7 Date of Final Inspection and Acceptance: r112-9 Inspected by: J OK to release deposits: 100% 75°% y Comments: 1PIervxS WC., ems, S= aka coo -- �� t e a s e �F dv f` eta,/ )00/1 � p.� CQs . Il CITY OF CAMPBELL PUBLIC WORKS DEPARTMENT CLEARANCE FOR FINAL INSPECTION AND ACCEPTANCE LETTER Encroachment Permit#: ENC 2016-00226 Name: ENC2016-00226 Property Address: 1875 S. Bascom Ave. (Pruneyard) Date of Final I ction: On File- Bonds CD Cash Faithful Performance: $ CIA)��o oa. Labor and Material: $ C osit to-ie released: $ Other overdue deposits to be released (Description): c�U r0VL5t,(0CA\'e^ r1 � �5�� �v,nuJ°=' U�D+� -Yltqk Processed by: z$�C 1— dm istrator Reviewed by: ffi —ti , Reviewed by: It L7( Land Development Engineer l JAJoAnnaT\Deposit refunds\CHECKLISTSTruneyard.doe(Rev. 10/11) To U RECORDED WITHOUT FEE SECTION 6103 GOVERNMENT CODE AT THE REQUEST OF CITY OF CAMPBELLE CI VE D Recording Requested by: ) 7 ArR 05 2017 '/I ) Regina Alcomendras- CITY CLERK'S-0ffi1Jl_. Santa Clara County - Clerk- City of Campbell . ) Recorder 02i07/2017 03:12 PM When recorded mail to: ) Titles: 1 Pages. 10 Fees: 0.00 City Clerk ) Taxes: 0 Cityof Campbell Tatal: 0.0@ 70 North First Street ) - III WRAIR 06WHIMODIN UahANAIMI),11111 Campbell, CA 9500.8 ) APN: 288-04-011,288-04-012,288-04-014, (Space above this line for Recorder's use only.) 288-04-017,288-04-025,288-04-026 ADDRESS: 1875, 1901, 1995& 1999 S Baseom Avenue,Campbell,CA 95008 S TRESET IMPROVEMENT AGR.EEME?NT RECITALS THIS AGREEMENT,identified.by File No(s).ENC2016-226,is entered into this Q Z D-day of • r,� �� � ,2017,by and between CFEP PRUNEYARD LLC, A DELAWARE LMTED LIABILITY COMPANY,hereunder referred to'as"Owner,"and the CITY OF CAMPBELL,a municipal corporation of the County of Santa Clara, State of California,hereinafter referred to as "City." On October 18, 2016 the City Council (Resolution No. 12069) granted conditional approval of a Tentative Vesting Parcel Map for that certain real property described in Document No. 22746352 recorded on October 21, 2014 in the Office of the Recorder of the County of Santa Clara,State of California and commonly known as 1875, 1901, 1995 & 1999 S Bascom Avenue,which property is Hereinafter referred to as "said real property." TERMS AND CONDITIONS, Now, therefore, in consideration of the above referenced approvals, and in satisfaction thereof, the parties to this Agreement shall comply with the following terms and conditions: (1) The Owner shall provide, construct and install.at his/her own proper cost and expense, street improvements as described in Section 11.24.040 of the City Code within 12 months from the date first mentioned hereinabove;provided,however,that in the computation of said 12 month period, delays due to, or caused by acts-of God, viz.,unusually inclement weather, major strikes, and other delays beyond the .control of the Owner or his/her successors shah be excluded. (2) If the Owner fails to complete the work required by this-Agreement within the said 12 month period, the City, after giving ten (10) days written notice to the Owner, or his/her successors, may construct and/or install said improvements and recover the full cost and expense from the Owner, or his/her successors.. (Rev 09115) 1 STREET IMPROVEMENT PLANS r - (3) The_Owner, shall cause to be prepared at his/her cost and expense street improvement plans for the construction and installation of said improvements prior to such construction t' or installation. Said plans shall be prepared by a civil engineer registered by the State of f California and submitted to the City Engineer for examination and approval. (4) All of said improvements embraced in this Agreement shall be constructed and installed in accordance with the plans approved by the City Engineer and .shall be made raider the inspection and to the satisfaction of the City Engineer. Said construction and/or installation shall be in accordance with the existing ordinances and resolutions of the City of Campbell and all applicable plans, specifications, standards, sizes, lines and grades approved by the City.Engineer, and all State and County statutes. Upon completion and acceptance of the improvements by the City,the Owner, shall provide reproducible as-built plans to the City Engineer. PLAN CHECK AND INSPECTION FEE (5) -Prior to approval of the plans by the City Engineer' pursuant to Section (3) of this- Agreement, Owner, or his/her successors, shall pay the City for plan checking of improvement plans, field inspection of construction of improvements and all necessary expenses incurred by City in connection with said improvements, a sum calculated in accordance with Resolution No. 10494 as adopted by the:City Council on May 3, 2005, or as may subsequently be adopted by the City Council. FAITHFUL PERFORMANCE SECURITY (6) The Owner, or his/her successors, shall file with City, prior to beginning construction, security acceptable,to the City in amount equal to the City Engineer's estimated cost of the street improvements to ensure full and faithful performance of the construction of all the aforementioned improvement work. Said security shall guarantee that Owner, and his/her successors, will correct any defects which may appear in said improvement work within one (1) year from the date of acceptance of the work by City and pay for any damage to other work resulting from the construction thereof, as well as pay the cost of all labor and materials involved. This security shall remain in effect until one (1)year after date of final acceptance of said improvements by City. Said security amount may be reduced by the City Engineer in his/her sole discretion after the date of final acceptance to not less than twenty-five(25)percent of its full value. (7) Upon final release of said security by City, the obligations of Owner, and his/her successors, contained in this Agreement:shall -be considered null and void, except as otherwise provided by applicable law, or Sections 12 or 13 of this Agreement. FORMATION OF A SPECIAL ASSESSMENT (8) The Owner, when called upon by City to do so, shall execute a petition for the formation of any special assessment district created pursuant to any special assessment act as provided in the Streets and Highways Code of the.State of California created for the purpose of constructing and/or installing any or all of said- improvements. Owner, or his/her successors, shall participate in and become a part of any special assessment district as described in Section(8) of this Agreement. (9) The Owner's, or his/her successors' obligations contained in this Agreement that are accomplished to the satisfaction of said City Engineer by said special assessment district shall be considered to satisfy those obligations. RIGHT-OF-WAY ACQUISITION (10) Owner at his/her own cost and expense, shall acquire any easement and right-of-way within or without said real property necessary for the completion of the improvements shown upon aforesaid improvement plans. It is provided, however, that in the event eminent.domain proceedings are required for the purpose of securing said easement and right-of-way, Owner, shall deposit or cause to be deposited with City a sum covering the reasonable market value of the land proposed to be taken and to be included in said sum shall be a reasonable allowance for severance damages, if any. It is further provided that in addition thereto such sums as may be required for legal fees and costs, engineering and other incidental costs shall be deposited with the City. (11) The Owner, shall carry out any and all negotiations with all interested parties and shall perform or cause to be performed at his/her own cost and expense and to the satisfaction of the City.Engineer any and all work required to abandon, remove, raise, lower, relocate and otherwise modify irrigation lines within or without the boundary of said real property. INDEMNITY AND INSURANCE (12) The Owner, and his/her successors, to the fullest extent permitted by law, shall indemnify, defend and hold the City of.Campbell, its agents, employees, attorneys, officers, officials and assignees harmless from any and all claims, actions, causes of action, liabilities, damages, losses and expenses, including, but not limited to, attorneys' fees, arising out of, or resulting from, or alleged to arise out of or result from any negligent or intentional act or omission(including misconduct)of said Owner,or his/her successors,or any subcontractor, or anyone directly or indirectly employed by him, or anyone for whose acts any of them may be liable in the course of performance of the Agreement, except for any claims, actions, causes of action, liabilities, damages, losses and expenses proximately caused by the sole negligence or willful misconduct of the City. (13) The Owner, and his/her successors, shall also indemnify, defend and hold the City of Campbell, its agents, attorneys, employees, officers, officials, and assignees harmless against and from any and all thralls, actions, cause of action, liabilities, demands, losses, lawsuits, judgments, damages, costs and expenses (including, but not limited to, attorneys' fees and court costs, whether incurred at trial, appellate or administrative levels) which the City of Campbell may incur or suffer, or to which the City of Campbell may be subjected resulting from, or alleged to result from the failure of Owner, or his/her heirs, assignees, successors, grantees, agents, employees, subcontractors, or anyone performing services under him, to fulfill any of the obligations imposed under this Agreement, except for any 3 claims, actions, causes of action, liabilities, judgments, damages, costs and expenses proximately caused by the sole negligence or willful misconduct of the City. (14) The Owner and his/her successors shall also indemnify,defend and hold harmless the City, its agents, officers and employees from any claim, action, or proceeding against the City or its agents, officers or,employees to attach, set aside, void.or annul an approval of the City, its City Council, Planning Commission, Community Development Director, Public Works. Director, Building Official, City Engineer, or other such City official concerning a subdivision, which action is brought within the time period provided for in California Government Code Section 66499.37. (15) In the event that this contract is subject to California Civil Code. section 2782(b), the foregoing indemnity provisions shall not apply to any liability for the active negligence of the City. The foregoing indemnity provisions are intended to fully allocate all risk of liability to third-parties. No other rights of indemnity or contribution shall exist between the parties in law or in equity. The provisions set forth in this section shall"survive the termination of this Agreement. (16) . The City will.promptly notify the Owner of any claim, action or proceeding to attack, set aside, void or annul any approval concerning a subdivision of said real property, and will cooperate fully in the defense. (17) Owner and his/her/its successors shall maintain insurance for injuries to persons or damage to property conforming to the following specifications: A. Minimum Scope of Insurance Coverage shall be at least as broad as: 1. Insurance Services Office(ISO)CGL form CG 00 01 11 85; and 2. ISO form G0009 11 88 Owners and Contractors Protective Liability Coverage Form—Coverage for Operations of Designated Contractor; and 3. Course of Construction Insurance covering all risks of loss; and 4.- ISO CA 00 01 06 92 including symbol 1 (Any Auto);and 5. Workers' Compensation insurance as required by the Labor Code of the State of California and Employer's Liability insurance. B. Minimum Limits of Insurance Owner shall maintain limits no less than: I. General Liability: $1,000,000 combined single limit per occurrence for bodily, personal injury and property damage. If Commercial General Liability Insurance or other form with a general aggregate limit is used, either the general aggregate limit shall .apply separately to this project/location or the general aggregate limit shall be twice the required 4 occurrence limit. 2. Automobile Liability: $1,000,000 combined single limit per accident for bodily injury and property damage. 3. Workers' Compensation and Employer's Liability: Workers' Compensation limits as required by the Labor Code of the State of California and Employer's Liability limits of$1,000,000 per accident. It is a requirement of this Agreement that any available insurance proceeds broader than or in excess of the specified minimum insurance coverage requirements and/or limits set forth " in this Agreement shall be available to the City as an additional insured. Furthermore, the requirements for-coverage and limits shall be (1) the minimum coverage limits specified in this Agreement, or (2) the broader coverage and maximum limits of coverage of any insurance policy or proceeds available to the named insured, whichever affords greater coverage. The limits of insurance required in this Agreement may be satisfied by a combination of primary and umbrella or excess insurance. Any umbrella or.excess insurance shall contain or be endorsed to contain a provision that such coverage shall also apply on a primary and non-contributory basis for the benefit of Cify (as agreed to in this Agreement) before the City's own insurance or self-insurance shall be called upon to protect it as a named insured. C. Deductible and Self-Insured Retention Any deductibles. or self-insured retention must be declared to and approved by the City. At the option of the City, either: the-insurer shall reduce or eliminate such deductibles or self-insured retention as respects the City, its agents, officers, attorneys, employees, officials and volunteers; or the Owner shall procure a bond guaranteeing payment of losses related to investigations, claim administration, and -defense expenses. D. Other Insurance Provisions The policies are to contain,or be endorsed to contain,the following provisions: 1. General Liability and Automobile Liability Coverage: a. The City, its agents, officers, attorneys, employees, officials and volunteers are to be covered as insureds as respects: liability arising out of activities related to this Agreement performed by or on behalf of the Owner, products and completed operations of the Owner, premises owned, occupied or used by the Owner, or automobiles - owned, leased, hired or borrowed by the Owner. b. The Owner's insurance coverage shall be primary insurance as respects the City, its agents, officers, attorneys, employees, officials and volunteers. Any insurance or self-insurance maintained by the City, its agents, officers, attorneys, employees, officials and volunteers shall be excess of the Owner's insurance and shall not contribute with it. C. Any failure to comply with reporting provisions of the policies shall 5 not affect coverage provided to the City, its agents, officers, attorneys, employees,officials, and volunteers. d. The Owner's'insurance shall apply separately to each insured against whom claim is made or suit is brought except with respect to the limits of the insurer's liability. e. Coverage shall not extend to any indemnity coverage for the active negligence of the City in any case where an agreement to indemnify the City would be invalid under Subdivision (b) of Section 2782 of the California Civil Code. 2. Workers'.Compensation and Employer's Liability Coverage:' The insurer shall agree to waive all rights of subrogation against the City, its agents, officers, attorneys, employees, officials, and volunteers.far losses arising from work performed by the Owner for the City. 3. Course of Construction Coverage: Course of Construction policies shall contain the following provisions: (a)the City shall be named as loss payee; and (b)the insurer shall waive all rights of subrogation against the City. 4. All Coverages:. Each insurance policy required by this clause shall be endorsed to state that coverage shall not be suspended, voided, canceled by either party, reduced in coverage or in limits except after thirty (30) days prior written notice by certified mail, return receipt requested, has been given to the City. E. Acceptability of Insurers Without limiting Owner's indemnification provided hereunder, Owner shall take out and maintain at all times during the life of this contract, up to the date of acceptance of the work by the City, the policies of insurance listed in Paragraphs 12 through 16 of this Agreement. Insurance is to be issued by an issuer with a current A.M. Best Rating of A:VII and be authorized to transact business in.the State of California, unless otherwise approved by the City. F. - Verification of Coverage Owner.shall furnish the City Nvith certificates of insurance evidencing coverage required by this clause. The certificates for each insurance policy are to be signed by a person authorized by that insurer to bind coverage on its behalf. The certificates are to be on forms provided by the City. Where by statue, the City Workers' Compensation related forms cannot be used, equivalent forms approved by the"Insurance Commissioner are to be substituted. All certificates are to be received and approved by the City before work commences. G. Subcontractors Owner shall 'include all subcontractors as insured under its policies or shall furnish separate certificates by each subcontractor. All coverage shall be subject to all of the requirements stated herein. 6 MUTUAL BENEFIT COVENANTS BINDING ON HEIRS, ASSIGNEES, SUCCESSORS, AND GRANTEES OF OWNER .08) It is acknowledged that the provisions of this Agreement constitute covenants for the improvement of the subject real property for the mutual benefit of Owner's_property, commonly known as 1875, 1901, 1995 & 1999 S Bascom Avenue, and the City's property, commonly described as S Bascom Avenue where it adjoins Owner's property. These covenants shall be considered to affect rights in the above-described real properties, and shall be binding on the heirs, assignees, successors, grantees and agents of the Owner to said real property. UNVESTED INTERESTS (19) Nothing contained herein shall be construed to transfer any unvested interests in real or personal property for purposes of the rule against perpetuities. BREACH OF CONTRACT (20) The City, upon breach any of the terms, conditions, or covenants of this Agreement by the Owners, shall be entitled to recover from the Owner, in addition to any other relief available in law or equity, all costs and compensation incurred in attempting to obtain enforcement of the Agreement,including reasonable attorneys'fees and court costs. ENTIRE AGREEMENT BINDING (21) This is the entire Agreement between the parties, and there are no representations, agreements, arrangements or understandings that are not fully expressed herein. This Agreement can be executed in counterparts by the parties hereto, and as so executed shall consist of one agreement,binding on all parties. PRELIMINARY PLANS (22) Owner shall provide and construct public street improvements per preliminary plans titled "STREET IMPROVEMENT PLANS — OFFSITE — 1875, 1901, 1995 & 1999 S Bascom Avenue (Pruneyard)," which are subject to approval by the City Engineer, prepared by HMH Engineers. 7 IN WITNESS WHEREOF, said City has caused its name to be affixed by its Public Works Director and City Clerk, who are duly authorized by Ordinance 2059 adopted September 20, 2005, . and said Owner has caused his/her name to be affixed the day and year first above written. OWNER CFEP PRUNEYARD LLC, A DELAWARE LIMITED LIABILITY COMPANY by: CFEP Regular Holdings LLC, a Delaware limited liability company its Sole Member by: EPL Pruneyard LLC, a California limited liability company its Administrative Manager by: Ellis Partners LLC a California limited liability company its Managing Member by: Name: elinda Ellis Evers Title: ylanaging Member l� CITY OF CAMPBELL Todd Capurso,Public Works Director City of Campbell {Notary'Acknowledgment for above signatories) MUST be attached.) Attest: Wendy 1010d, City Clerk 8 -. A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy, or validity of that document. STATE OF CALIFORNIA) COUNTY OF SAN FRANCISCO) On January 23, 2017,before me, Shawn A.Christman,Notary Public,personally appeared Melinda Ellis Evers, who-proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that- he/she/they executed the same in his/her/their authorized capacity,and that by his/her/their signature on the instrument the person(s),or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. � r Signature8� [Seal] SHA iAt A.CHRISTMAN toi ilifth#2462952 Notary Public:Ca6firnia z &anfr�flci�cbCoa�4y ' Coita-h,% ire -MarX Zola CALIFORNIA ALL® PURPOSE, CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of On ]� before me, �r `�;�t.tv�c� ,.�... t Div i ra (Here risen name and fare of the on ice') personally ap eared fit;rt' G� � who.proved to me on the basis Of satisfactory.evidence to be the-person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that hefshe/they executed the same in his/her/their.auth.orized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument- I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. JOANN THOMASON ITNESS my hand and official seal. '< Commission#2110789 z i z o Notary Public-California z a, � z Santa Clara County My Comm.Expires May 9,2019 o. ``.. ,�` -�✓ Notary Public-. nat—. (Notary Public Seal) t, ` ,- ' INSTRUCTIONS.FOR COWLETING THIS FORM ADDITIONAE'OPTIONAL IN F.O. MATION Thisfonn complies ivith cument California statutes regarding notary mording and, DESCRIPTION OF THE ATTACHED DOCUMENT if needed,should be completed and attached to the document.AcAmawledgments front other states maj,be completed for documents being sent to that state so long 4� as the wording does not require the California notary to violate Califoniia notarr @-1S01i lrnn• (title or description of attached document) ® State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. k( A' ,c c+6 . pate of notarization must be the date that the signer(s)personally appeared which (title or description of allached document continued) must also be the same date the acknowledgment is completed. Number of Pages Document Date ® •Ilse notary public must print his or her name as it appears within his or her commission followed by a comma and then your title(notary public). • Print the name(s) of document signer(s) who personally appear at the time of notarization. CA dACrry CL.A HMEO BY THE—SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. he/she/gie} is)are)or circling the correct forms.-Failure to correctly indicate this ❑ IndividU31(S) information may lead to rejection of document recording. ❑ Corporate Officer • The notary seal impression must be clear and photographically reproducible. Impression must net cover text or lines. if seal impression smudges,re-sea{d a (Title) sufficient area permits,otherwise complete a different acknowledgment form. ❑ Pbrtner(s) Signature of the notary public must match the signature on file with the office of the county clerk. © Attorney-in-Fact Additional information is not required but could help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document. ❑ Other Indicate title or type of attached document,number of pages and date. • Indicate the capacity claimed by the signer. If the claimed.capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Ver�,iaR t•;y,;;.Net rruCtass2 .;orn Su -S8 5 Securely attach this document to the signed document with a staple- Recording Requested By: ) 24072635 JAN 14 2019 Regina Alcomendr Santa Clara County - Clerk-Recorder City of Campbell ) , gr.���'a�fl $� } 11/30/2018 08:13 AM And When Recorded Return To: } Titles: 1 Pages: 2 City ) Fees: $13.00 ty Clerk } Taxes: 0 City of Campbell ) Total: $1.q3.,000 pp� '4 p ` 70 N.First Street } mill[i'J'i�Iifl�lYNNNIIN VIW�MI�'�f��4CW 11II` Campbell,CA 95008 ) APN: 288-04-011,208-04-012,288-04-014 (Space Above This Line For Recorder's Use Only) 288-04-017,288-04-025,288-04-026 ADDRESS: 1875, 1901, 1995& 1999 S. Bascom Ave.,Campbell,CA 95008 NOTICE OF RELEASE BY CITY OF CAMPBELL NOTICE IS HEREBY GIVEN concerning the real property located in the City of Campbell, Santa Clara County, California, and described specifically as follows: 1875, 1901, 1995 & 1999 S.Bascom Avenue, Campbell, CA. That whereas, CFEP PRUNEYARD LLC,a Delaware Limited Liability Company,entered into a Street Improvement Agreement with the City of Campbell, recorded February 7, 2017, Document #23578200 in the Office of the County Recorder, County of Santa Clara, State of . California. That, whereas, said conditions of said Agreement have been met to the satisfaction of the City. That,Now Therefore CFEP-PRUNEYARD LLC,is hereby released from all requirements contained in the agreement recorded February 7, 2017, Document#23578200, in said County Recorder's Office. IN WITNESS WHEREOF, said City has caused its name to be affixed by its City Engineer and City Clerk, who are duly authorized by Ordinance 2059 adopted September 20, 2005. +Amylay C MPBE ATTEST: eer, ity of Campbell J dw'-VA. 19j endy .od, City berk (Attach Notary Acknowledgment) Dated: f CALIFORNIA ALL-PURPOSE CERTIFICATE OF ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity- of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California } County of On N w fvtiW--f 2J; o t before me, v�a�M tom) ere mse Hama a,rat!o the o iceq — personally appeared k\f1C11' - 0\ who proved to me on the basis f satisfact evidence to be the person(s)whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. JOANN THOMASON NESS m hand and official seal. Commission#21107ni y z Notary Public-California i z ' Santa Clara County n My Comm.Expires May 9,2019 N ry Pu 'c tgnature (Notary Public Seal) ADDITIONAL OPTIONAL INFORMATION INSTRUCTIONS FOR COMPLETING THIS FORM Thisform complies with current California statutes regarding notary wording and, DESCRIPTION OF THE ATTACHED DOCUMENT fneeded,should be completed and attached io the document.Acknowledgments from other states may be completed for documents being sent to that state so long nn as the wording does not require the California notary to violate California notary Rek''cAS e- law. �tle or description of attadted document) • State and County information must be the State and County where the document signer(s)personally appeared before the notary public for acknowledgment. . Date of notarization must be the date that the signer(s)personally appeared which (rite or description of attached document continued) must also be the same date the acknowledgment is completed. • The notary public must print his or her name as it appears within his or her Number of Pages Document Date conunission followed by a comma and then your title(notary public). . Print the name(s)of document signer(s) who personally appear at the time of notarization. CAPACITY CLAIMED BY THE SIGNER • Indicate the correct singular or plural forms by crossing off incorrect forms(i.e. lte/she/they,—is/are)or circling the correct forms.Failure to correctly indicate this ❑ Individual(s) information may lead to rejection of document recording. ❑ Corporate Officer rite notary seal impression must be clear and photographically reproducible. Impression must not cover text or lines.If seal impression smudges,re-seal if a (Title) sufficient area pemriis,otherwise complete a different acknowledgment form. ❑ Partner(s) • Signature of the notary public must match the signature on file with the office of the county clerk. ❑ Attorney-in-Fact Additional information is not required but could.help to ensure this ❑ Trustee(s) acknowledgment is not misused or attached to a different document Other Indicate title or typo of attached document,number of pages and date. ❑ Indicate the capacity claimed by the signer.If the claimed capacity is a corporate officer,indicate the title(i.e.CEO,CFO,Secretary). 2015 Version www.NotaryClasses.com 800-873-9865 Securely attach this document to the signed document with a staple. l Syed Wahidi From: Syed Wahidi Sent: Tuesday, April 16, 2019 11:58 AM To: 'Shawn Christman' Cc: Doris Quai Hoi;.'Jeff Williams' Subject: RE: 3655.10 Pruneyard Monument Bond Release Attachments: RE: 3655.10 — RE: Pruneyard Monument Bond Release Hi Shawn, Regarding monument bond release, please see the attached letter sent to Tracy. OV•cA,y Syed Wahidi A��t Public Works Inspector U r City of Campbell I Public Works Department 0 0 70 N. First Street I Campbell,CA 95008 www.cityofcampbell.com 1408.866.2165 From: Doris Quai Hoi Sent: Tuesday, April 16, 2019 8:28 AM To: Syed Wahidi- Cc: JoAnna Thomason Subject: FW: 3655.10 Pruneyard Monument Bond Release Syed, please could you follow up on this bond. Thanks, Doris From: Shawn Christman [mailto:shawn0ellispartners.com] Sent: Wednesday, April 10, 2019 3:26 PM To: Doris Quai Hoi; jwilliamsOhmhca.com Cc: Rubinson, Dean J. Subject: 3655.10 Pruneyard Monument Bond Release WARNING: This email originated from an external sender! Doris and Jeff- Attached is the monument bond release letter for The Pruneyard signed by the surveyor and CFEP Pruneyard LLC. Shawn Shawn A. Christman Assistant Development Manager ELLIS PA RUNEIR. 1 111 Sutter Street, Suite 800 San Francisco,CA 94104 415.391.9800 www.ellispartneis.com This message contains information which may be confidential and privileged. Unless you are the addressee(or authorized to receive for the addressee),you may not use,copy or disclose to anyone the message or any information contained in the message. If you have received the message in error,please advise me by reply email and delete the message. Thank you. 2 Syed hid! From: SvedVVahidi ' Sent Friday, March O8, 20l9l2:4lPM To: 'Tracy Giorgetti' Subject: RE: ]6SS.lO ~ RE: Pruneyard Monument Bond Release HiTracy, According toengineer, surveyor need to do a Certificate of Correction, since they are not setting the monuments consistent Whhthe recorded Parcel Map. They need to set offset replacement monuments and then memorial that change with the Certificate ofCorrection. Thanks. SyedWohidi Public Works Inspector 15, From: Tracy Giorgetti [ Sent: Friday, MavchO8, 2019 11:16AM To: SyedVVahidi Subject: RE: 3655.10 — RE: Pruneynrd Monument Bond Release WARNING: This email originated from an external sender! HiSyed, As discussed, see the field notes below for the iron pipSe not set due to a tree root and water main. ' \ 1 :Lb l 0,00 CL VA,IN IP 0.00 did no -set.' _ ... .. . ..., � � y� t n x��" w"Cs �',�--fin r�, P"' S •t"z Fy� . M] `� r w �4 fya. 1�'�tv- ^�YiYgS�� .'jb�����t `..•,����.^ � S4� af� �"� ,�3� �,�`" �^`.� XA"A�y �d+ys yy'' Ck�°'` h f p 4dM &Y ou ^^^...."•'e..'^^^' _ - ., � iT`�mm `+ kMOS4 TS '`T t .• "x+`tT' _ s R l A 'w i y �•sy�� $� I •CTX2 wg ij U ii O RIVU itf � • xi85A 7 �py "i }�„� � 44 S'..r+Y ES"pis i'vo Y1"4 'S - opw EAST CAMPBE f AVENUE�?Lzi Tracy Giorgetti, PE, LS Senior Land Surveyor 408.487.2200 x5619 tr;iorr;etti@hmhca.com 1570 Oakland Road San Jose I CA 195131 uvww.hmhca.com anrww.hmhlastudio.com 2 From: Syed Wahidi Sent: Monday, December 24, 2018 7:42 AM To:Tracy Giorgetti Cc: Doris Quai Hoi; 'Shawn Christman' Subject: RE: 3655.10— RE: Pruneyard Monument Bond Release Unfortunately this did not help as I was unable to locate any marker in the outside area to start with. Please schedule a field visit after holidays. OVz CA41�, Syed Wahidi ��, Public Works Inspector r City of Campbell Public Works Department 70 N. First Street Campbell, CA 95008 www.cityofcampbell.com 408.866.2165 •�$Ct10t9 From:Tracy Giorgetti [ma„ilto.,;tg,i �,-g,e. t,i,.,.�f NMHc, ,,c,a,r11] Sent: Friday, December 21, 2018 3:35 PM To: Syed Wahidi Cc: Doris Quai Hoi; 'Shawn Christman' Subject: 3655.10" RE: Pruneyard Monument Bond Release WARNING:This email originated from an external sender! Hi Syed, I have overlaid the aerial planimetrics onto the map for your use. If that is not helpful, we can schedule a site walk. Please let me know. Happy Holidays! Tracy Tracy Giorgetti, PE, LS Senior Land Surveyor 408.487.2200 x5619 tgiorgetti@hmhca.com 1570 Oakland Road San Jose CA 95131 wmtw.hmhca.com www,hmhlastudio.com From: Syed Wahidi <SyedWCa@cityofcampbell.com> Sent: Wednesday, December 19, 2018 12:25 PM To:Tracy Giorgetti <t&iorgetti@HMljca.com> Cc: Doris Quai Hoi <doris h a)cityofcaraipbell.corn>; 'Shawn Christman' <shawn cx ellispartners.com> Subject: Pruneyard Monument Bond Release Hi Tracy, 3 — I am unable to find the markers. Is it possible if someone could walk with me to show the monuments/markers?Thx. pt CA41�6 Syed Wahidi A' Public Works Inspector r� r City of Campbell I Public Works Department 70 N. First Street I Campbell, CA 95008 www.cityofcampbell.com 1 408.866.2165 •CkC11 4 )2Lj 2 ) )City of Campbell IDWYS 1rz)e. Department of Public Works 70 North First Street Campbell,CA 95008 SUB. d"1': MONUMENT BOND RELEASE .PARCEL MAPY. I TACT MAP Nq . :�„����; ��" '�ti•`t'i`°���Z... T;es orded in Book ......l1`I......... . ..:......:.... f Dear City Engineer: In conformance with the requirements of Section 66497 of the Subdivision Map Act,please be advised that the Engineer/Surveyor has been paid in frill for setting the monuments within the above described subdivision. It is requested that Monument Bond Cash Deposit in the amount of.,..................:.......,: ; be released. , ro Developer/Agent P.' Date of signature of this document E Gl RTJF$CA]:E:O ::ENQ1'S1• I+RtaleSURVEYOR j ..,.. 6 ,.... ,.... �.�.,.s. 7 4'.. ...,.....,certify that all monuments as shown on the map of the t above described subdivision are now set and that payment in full for this work has been received. G1p ,G '�� Civil Engineer cif land Surveyor pal L5 �-7 tp a/zo License number Expiration date No. 8720 ;p T.j /51 Date of signature.of this document nit)"Il'lE: 'raeessiitif-i nil eefense rnnnot cicctu-unless all of the ahoveinformation is complete. CITY OF CAMI'BELL City Inspector Date Comments: Rev.09/2014 os E; I .j i I. JIII II'l .:.s.' y:i..(.R.:r ». ! � e .. j,..•��:.t'4�� ( 1 ! � y.. 4 '4ri( ; I j ...: i c w Is- N —^r r t.0 :, "71S.2,2 'T•'`Y"�ji.,•�t,_.� .1 -.a-_, I.1 I� t. .. R2t'r5s f ,fi :1 <k: .< a.7 r� .i., r .. c�W, I I I I �.r ,J' i'f �' j n •. i.....-.w My f��4 T' a.'�< . �� ; � _ - . 1 i yam, r a .rSO ..(d.(r]4ddU I �` ,' ' .O UMIN ... I IZ � ,._• .-'``<C � vil.�. Xit•.rH Nvaml ..... ,avy:-y .•+•l,naw.,:�i.,,.ev�-?,w,'rg4.,-.vvrvA ..... _ - — ! i 7 I y i. r•t:- '`,�i•'J ram'` i ;w„�....r-..; .Nm a <`: !9 61 RDI i - f7iC1 �� I'r� I: �.7 ��:a - �:+..... .. ! :' ' .'x-• .. ..":�. - ._sir ,�•,:` '., .> { � 1.}i 1 =' { r i 4' i. SD 4. :I r . 1 • r a . � ,.••--Nr�•r.,,y;�-, a: art, .,;; ��, T;_ ,... •ye' -- -:thy>%'—"�:- ,- .o.-:e';�'.'' "M":'.'�.,"�T:" v..•-'s"-:` .:.._._:'...� a:.,;a/:>:.� — Syed Wahidi From: Syed Wahidi Sent: Tuesday,August 07, 2018 3:52 PM To: 'Jim Sanford' Cc: ' Mark JR. Blackwell '; 'JoeBrown@Blackwellge.com'; Doris Quai Hoi Subject: RE: Read: RE: Site Work-Walk Through Attachments: SKM BT_50118080715450.pdf Jim, We are still waiting for the last one (storm capture device)to be installed (sketch attached). ov•CA4 Syed Wahidi �4'44' ��F, Public Works Inspector U �r City of Campbell I Public Works Department 0o 70 N.Fist Street I Campbell,CA 95008 www.cityofcampbell.com 1408.866.2165 From: Syed Wahidi Sent: Thursday, June 21, 2018 11:14 AM To: 'Jim Sanford' Cc: Mark JR. Blackwell ; JoeBrown(cbBlackwellge.com; Doris Quai Hoi Subject: RE: Read: RE: Site Work-Walk Through Doris, I am ok to leave the one by Marshall's as is. But it's your call. r Jim, Please let me know when the last one gets installed. oV•CA,y, Syed Wahidi ; Public Works Inspector U r City of Campbell I Public Works Department 0 o 70 N.First Street I Campbell,CA 95008 A t www.cityofcampbell.com 1408.866.2165 . ogg0' From: Jim Sanford [mailto:jim.sanford@wlbutler.com] Sent: Thursday,June 21, 2018 8:29 AM To: Syed Wahidi Cc: Mark JR. Blackwell ; JoeBrownaBlackwellge.com; Doris Quai Hoi Subject: Re: Read: RE: Site Work-Walk Through Morning Syed, I have met with Blackwell on site and the trash capturing device that is to be relocated by Marshalls could not be installed because they could not remove the grate. Can we leave this one where it is? Other trash capturing 1 device was not ordered and has been ordered. They are telling me that it will be 6 weeks out because it's a special order. I will let you know when it has been installed. Thank you and have a nice day. Sent from my Whone On Jun 19, 2018, at 1:11 PM, Syed Wahidi <SyedW cityofcampbell.com>wrote: Your message To: Syed Wahidi Subject:RE: Site Work-Walk Through Sent: Tuesday,June 19,2018 11:15:40 AM(UTC-08:00)Pacific Time(US&Canada) was read on Tuesday,June 19,2018 1:11:19 PM(UTC-08:00)Pacific Time(US&Canada). <mime-attachment> 2 Syed Wahidi From: Syed Wahidi Sent: Monday,April 09, 2018 7:59 AM To: Doris Quai Hoi; 'Jim Sanford' Subject: RE: Site Work -Walk Through Attachments: SKMBT_50118040907490.pdf Hi Jim, I checked out the trash capture devices. One is missing and other one need to be relocated . Please see attached sketch. OV•CAS Syed Wahidi ���� Public Works Inspector U r+ City of Campbell I Public Works Department o o 70 N.First Street I Campbell,CA 95008 4� . www.cityofcampbell.com 1408.866.2165 From: Syed Wahidi Sent: Thursday, February 08, 2018 1:35 PM To: Doris Quai Hoi; 'Jim Sanford' Subject: RE: Site Work-Walk Through After walkthrough today with Jim, project has been conditionally signed off. Deposit will be released after the remaining 6 trash capture devices are installed. OF•cam Syed Wahidi Public Works Inspector U City of Campbell I Public Works Department 0 *41 0 70 N.Fist Street I Campbell,CA 95008 www.ciiyofeampbell.com 1408.866.2165 From: Doris Quai Hoi Sent: Wednesday, February 07, 2018 9:51 AM To: Syed Wahidi Subject: FW: Site Work-Walk Through FYI Jim is looking for sign off. You okay with it? From: Jim Sanford [mailto:jim.sanford(&wlbutler.com] Sent: Wednesday, February 07, 2018 9:47 AM To: Katie Parker; Charlie Kelly; Kevin McIntire i Cc: Daniel Fama; Doris Quai Hol; Robert Luna Subject: RE: Site Work- Walk Through SEE BELOW IN RED From: Katie Parker[mailto:kparker@ellispartners.com] Sent: Monday, February 05, 2018 3:08 PM To:Jim Sanford <iim.sanford Owl butler.com>; Charlie Kelly<Charlie.Kelly@wlbutler.com>; Kevin McIntire <kmcintire@Pacificsurfacing.com> Subject: FW:Site Work-Walk Through Jim/Charlie See list below from DPW. Kevin—The first bullet is in your scope. I expected this to be completed last week. What is the status? Katie From: Daniel Fama [mailto:danielf@cityofcampbell.com] Sent: Monday, February 05, 2018 1:47 PM To: Katie Parker<kparker@ellispartners.com> Cc: Doris Quai Hoi<dorisgh@citvofcampbell.com> Subject:Site Work-Walk Through Hi Katie—Here are a few notes for the site work that need to be addressed prior to final • Install striping at N/E corner entry COMPLETE • Install lane striping around the corner adjacent to BofA COMPLETE • Remove all unpermitted temporary signs (such as easterly Campbell Avenue driveway) WE HAVE NO TEMP SIGNS • Clean site of all debris, mulch, soil, etc. not related to an active tenant improvement ALL HAVE BEEN REMOVED FROM OUR WORK ON SITE. • Provide Certificate of Completion and Irrigation Audit Report (see example) confirming that all landscaping and irrigation was installed per plan THIS WILL BE COMPLETE MONDAY 2-12-18 1:OOPM • Provide a written confirmation that all parking stalls have been striped per plan for this phase ALL PARKING STALLS HAVE BEEN INSTALLED PER PLAN (PERMIT 2016-01557) SEE PDF Thanks Daniel 2 i . AR TRUCK ROUTE ENTRAP { �. y.... �� — o�$p _ �5D�•--SD ----SD SD,:� D3p----�D--._.o__ O i t ' ! .I -i , l � rf �� �I. � ! Ili I ilrtl jif� ',�,�. � '�� •�[`` •,l , _,1 . I SD SD— .............•.., .. N5 I f i (+ IN to I ( .....,,...., _..�._ idol r , w I - _ iN :v I I TYPE C(TYP) C5,1 INLET PROTECTION o /05 _. fh p i , . I p .- .— � . , � �'`• �� [.-� ..�.,. ,:.�i SE-5 FIBER ROLL P I N El LU 10 I m i I :'"; _LSD. r-SD`• D�r �' o # i � � 1 I I I # J� I ± N . .... ......._..__ ._.. i_ ;` .. _ I Gs. _.. l D_JUS i .:. ... .....:..:............ 0 I n 1s rfl SD »; 5 � l il4 � I � _.. - I I I i 1 ` SD _ X21'SD50 O SD SD EX 185D_ S� _- StL O— qD _ SD-- ''O•- '� �' y Syed Wahidi From Syed Wahidi Sent: Thursday, February 08, 2018 1:35 PM To: Doris Quai Hoi; 'Jim Sanford' Subject: RE: Site Work-Walk Through After walkthrough today with Jim, project has been conditionally signed off. Deposit will be released after the remaining 6 trash capture devices are installed. OV-CnM�o Syed Wahidi HIV �� Public Works Inspector U �r City of Campbell I Public Works Department 0 o 70 N. First Street I Campbell, CA 95008 www.cityotcainpbell.com 1408.866.2165 From: Doris.Quaff Hoi Sent: Wednesday, February 07; 2018 9:51 AM To: Syed-Wahidi Subject: FW: Site Work- Walk Through FYI Jim is looking for sign off. You okay with it? From: Jim Sanford [ma ilto:jim.sa nford O)wl butler.com] Sent: Wednesday, February 07, 2018 9:47 AM To: Katie Parker; Charlie Kelly; Kevin McIntire Cc: Daniel Fama; Doris Quai Hoi; Robert Luna Subject: RE: Site Work- Walk Through SEE BELOW IN RED From: Katie Parker [mailto:kparker@ellispartners.com] Sent: Monday, February 05, 2018 3:08 PM To:Jim Sanford <iim.sanford@wlbutler.com>; Charlie Kelly<Charlie.Kelly@wlbutler.com>; Kevin McIntire <kmcintire@pacificsurfacing.com> Subject: FW:Site Work-Walk Through Jim/Charlie—See list below from DPW. Kevin—The first bullet is in your scope. I expected this to be completed last week. What is the status? Katie 1 Syed Wahidi From: Syed Wahidi Sent: Friday,January 19, 2018 11:10 AM To: 'Jim Sanford' Cc: Doris Quai Hoi;John Burchfiel Subject: . :. Pruneyard Jim, Doris mentioned there is some missing striping along Campbell Ave also. Please have it done too.Thanks. 1 will be on vacation till Feb'2nd. Remaining items are:. 9 trash capture devices - - e ins Missing striping along4a e.14-Ave-and on the back side - CDwy-#6-ee-Pter-1ine-s-tripe ✓ . 5z oV•cnl,4 Syed Wahidi _ ���, Public Works Inspector U tr City of Campbell I Public Works Department 0 o 10 N.First Street I Campbell,CA 95008 s� o� www.cityofcampbeil.corn 1 408,866.2165 •�RCHARO. 1 Syed Wahidi From: Syed Wahidi Sent: Friday,January 05, 2018 11:39 AM To: 'Charlie Kelly' Cc: Jim Sanford; David Mooso; Doris Quai Hoi; Katie Parker Subject: RE: Pruneyard Hi Charlie, The reason we are going back to original claim to replace the lids and fix the grout because according to our electrician Dave,the lids were there and very likely got damaged during construction and were replaced with these non-standard lids. Also,our electrical dept do not recall seeing this crappy grout in these service boxes before. Though you claim you did not move the box or re-grouted, someone must have done the grout during this project. Existing grout does not take much to be broken when jack hammered immediate next to the service boxes as apparently happened in this project. oV•C� Syed Wahidi �4, �� Public Works Inspector U City of Campbell I Public Works Department 0 o 70 N. First Street I Campbell, CA 95008 Get www.cityofca.mpbell.com 1408.866.2165 From: Charlie Kelly [ma i Ito:Cha rl ie.Kel ly wlbutler.com] Sent: Tuesday, January 02, 2018 1:48 PM To: Syed Wahidi 'Cc: Jim Sanford; David Mooso; Doris Quai Hoi; Katie Parker Subject: RE: Pruneyard Hello Sayed, The last time we met on-site to discuss the punch list items listed for our off-site permit it was agreed that the electrical lids are not shown to be changed out on our permit and we did absolutely no work on or in them.The same goes for the boxes by driveway#6.While it does appear the work inside them was"done poorly" it was NOT done by us or included in our permit to touch them, so we didn't. In summary, and as agreed to during your last inspection the following items are in progress and will be done shortly: Campbell lids ean H ,,..,teased fFGFn 'EleC Fical DiStFib�', Not shown on our permit and not touched by us City electrician Fe evaluated the twe service bexes next to dwy#6 and found that they Fequire gFOUt tG be done prepeFly per City standard detail. Not shown on our permit and not touched by us Here is a list of remaining works: -Construct dry well next to trash area DON - Per Sheet C 4.0, note 9, install trash capture device in all on-site catch basins We are working vvith ov✓nership to,get this ...,. .., done - Repair Not shown on our permit and not touched,by.;us Install sign R9-3bP north side of dwy#6 per plan In Progress 1 Remove catch basin protection In progress -Submit as-built drawings upon completion of project In progress Charlie Kelly Senior Project Manager W. L. Butler 140,Frank West Circle, Ste 100 Stockton, CA 95206-4045 209.983.4890 Main 1209.9814891 Fax www.wlbutler.com BUILDING WHAT MATTERS Redwood City I Irvine I Stockton I Livermore "LEED" by example and consider the environment before you print this document This email is confidential and privileged and is intended only for the stated recipient. If you receive this message in error, please contact the sender and delete this message, and any attachments. Any review, use, dissemination or copying of this message, except by the intended recipient, is strictly prohibited. From:Jim Sanford Sent:Tuesday,January 02,2018 1:30 PM To: Charlie Kelly<Charlie.Kelly(@wlbutier.com> Subject: Fwd: Pruneyard FYI Sent from my iPhone Begin forwarded message: From:Syed Wahidi <> Date:January 2, 2018 at 12:33:21 PM PST To: 'Jim Sanford'<iim.sanford@wlbutler.com> Cc: David Mooso<>, Doris Quai Hoi < > Subject: RE: Pruneyard Jim, Campbell lids can be purchased from 'Electrical Distributors'. City electrician re-evaluated the two service boxes next to dwy#6 and found that they require grout to be done properly per City standard detail. Here is a list of remaining works: G et dFy well next to trash area. DONE - Per Sheet C 4.0, note 9, install trash capture device in all on-site catch basins 2 ° - Repair two street light service boxes next to dwy#6 (Grout that was done was not adequate) 4 - Install sign R9-3bP north side of dwy#6 per plan - Remove catch basin protection -Submit as-built drawings upon completion of project OV•C Syed Wahidi Public Works Inspector Ga 'ee City of Campbell Public Works Department a o 70 N.First Street Campbell,CA 95008 Ah www.cityofcampbell.com 408.866.2165 3 Syed Wahidi From: Syed Wahidi Sent: Tuesday,January 02, 2018 12:33 PM To: 'Jim Sanford' Cc: David Mooso; Doris Quai Hoi Subject: RE: Pruneyard Jim, Campbell lids can be purchased from 'Electrical Distributors'. City electrician re-evaluated the two service boxes next to dwy#6 and found that they require grout to be done properly per City standard detail. Here is a list of remaining works: --Eaff5tPd44 y-we"- _-44G-t+-asb-a-rea. DONE - Per Sheet C 4.0, note 9, install trash capture device in all on-site catch basins - Repair two street light service boxes next to dwy#6 (Grout that was done was not adequate) - Install sign R9-3bP north side of dwy#6 per plan - Remove catch basin protection -Submit as-built drawings upon completion of project OV•CAS Syed Wahidi 44' �� Public Works Inspector U r . City of Campbell I Public.Works Department 0 o 70 ITT. First Street I Campbell,CA 95008 4 ''' www.citypfcampbell.com ofcampbell.com 1408.866.2165 •�RCHAIt� 1 Syed Wahidi From: Syed Wahidi Sent: Tuesday, November 14, 2017 1:22 PM To: Jim Sanford Cc: David Mooso; Doris Quai Hoi; Syed Wahidi Subject: Pruneyard Attachments: 1875 Bascom Ave - GD - BLD 2016-1557 Sht.C4.0.tif Dave, Please check out the service box next to North driveway on Winchester Blvd at the South West corner.Thx. Doris, Do we have an approved set of trash enclosure plans? Jim, Acc to Sheet C 4.0, note 9,trash capture device shall be installed in all on-site catch basins. (see attached). Here is a list of remaining works: -Construct dry well next to trash area. - Install trash capture device at all CB's on-site 0 - Install sign R9-3bP north side of dwy#6 per plan - Remove catch basin protection -Submit as-built drawings upon completion of project OV•CA44 Syed Wahidi A��t Public Works Inspector Vr City of Campbell I Public Works Department 0 o 70 N.First Street I Campbell,CA 95008 www.cityofcampbell.com 1408.866.2165 •0RCH�R� From: Doris Quai Hoi Sent: Tuesday, November 14, 2017 8:56 AM To: Syed Wahidi Subject: Full Trash Capture Device - Pruneyard Syed, Sheet C4. Note 9 OV•CA,t4 Doris C. Quai Hoi Assistant Engineer V City of Campbell Public Works Department 0 o 70 N. First Street Campbell,CA 95008 www.citvofcampbell.com 1TR 408.866.2157 •ORCHARD 1 L 1 / City of Campbell Punch List For Bascom Ave @ Pruneyard Traffic Signal Pull Box's Nov. 15, 2017 South-West corner Traffic Signal null box about 10" West of pole 0 Pull box lid should read"Campbell Traffic Signal". 0 Grout is very sloppy Grout work is poor quality. It should be nice a smooth. 0 Grout is touching the lip of the conduit. It should be 1"to 2"below the lip of the conduit. See page E-5 of our City specifications detail. South-West corner Traffic Signal pull box Just North of pole 0 Grout work is poor quality. It should be nice a smooth. South-West corner Traffic Signal pull box oust North of pole 0 Grout work is poor.quality. It should be nice a smooth. TloGard.+Plus® Standard Catch Basin Insert l Oldcastle Page 1 of 3 . 1. .TOO Q (88B)965-3227 I FLOGARD +PLUS° STANDARD CATCH BASIN INSERT ............ e OVERVIEW FEATURES BENEFITS DOWNLOADS https://oldeastleprecast.com/oldcastle_product/24x24-flogard-catch-basin-insert-2/ 11/15/2017 PloGard+Plus® Standard Catch Basin Insert I Oldcastle „. Page 2 of 3 O The FloG.ard+Plus is a catch basin insert that provides physical screening of pollutants such as gross solids, trash and debris using a filter fabric basket for removal of petroleum hydrocarbons using sorbent pouches.It is ideally suited for removal of primary pollutants from paved surfaces in commercial and residential areas. Available in a wide variety of sizes and configurations,the FloGard can be incorporated in most industry-standard flat-grated and combination drainage inlets by suspending the device from the catch basin frame underneath the grate.The FLoGard insert has a shallow profile,contains a high-flow bypass and is ideal for applications where water needs to be sampled after treatment.As with any stormwater treatment system, the FloGard requires regular maintenance to prolong the life of*ho eve+nm Dnutino mointona nnu ie or•nmm�liehorl .' Read More FLOGARD+PLUS® LOOKING FOR STANDARD CATCH BASIN ADDITIONAL INSERT FILTER INFORMATION? The standard FLoGard+Plus ►. REQUEST A Catch Basin Insert Filter is a QUOTE basic catch basin insert that removes pollutants from stormwater runoff coming from paved surfaces in commercial and residential areas. � MODEL: FLODARD®CATCH BASIN INSERT FILTER FOP-CB MFG PLANT: National DIMENSIONS: �•��-�_-�.-�� Sizes Vary https://oldcas.tleprecast.com/oldcastle_product/24x24-flogard-catch-basin-insert-2/ 11/15/2017 VloGard+Plus® Standard Catch Basin Insert I Oldcastle Page 3 of 3 RELATED PRODUCTS Detention/Retention Y Pipe 3 M.,s Bioretention/Biofiltration 0 'a 6 .ate` sPck dg t https:Holdcastleprecast.corri/oldcastle_product/24x24-flogard-catch-basin-insert-2/ 11/15/2017 Joy Francois From: Roger Storz Sent: Wednesday, February 08, 2017 1:08 PM To: Carolina Vargas;Joy Francois Cc: Doris Quai Hoi; Matthew Jue; Fred Ho;Amy Olay;Jesse Takahashi Subject: RE: Prunyard Contributions Attachments: Remainder fees paid.pdf Hi Carolina, The $135,000 collected should be put into 2203 (deposit). Ideally, it could show up as three separate deposits, as these contributions are ultimately going to be transferred to three different City projects: �4{oU $45,000 for the Campisi Way Feasibility Stud 1, ® $40,000 for Traffic Signal equipment • $50,000 for Green Bike Lanes v- Thank you for your help, and please let me know if you need any additional information. Thank you, Roger Storz, PE City of Campbell (408) 866-2190 (direct) rogers(a-),cityofcampbell.com Land Development Website From: Roger Storz Sent: Wednesday, February 08, 2017 12:52 PM To: Joy Francois; Carolina Vargas Cc: Doris Quai Hoi Subject: RE: Prunyard fee Hi Carolina, We will need to change some of the money collected from 4722 to 2203 (deposit). I'll come down to identify which ones need to be changed. Thank you, Roger Storz, PE City of Campbell (408) 866-2190 (direct) rogers(a-)cityofcampbell.com Land Development Website From: Joy Francois Sent: Wednesday, February 08, 2017 12:08 PM To: Roger Storz Subject: Prunyard fee I talked to Carolina and she said you need to let her know today if you want to change from 4722 to 2203 (deposit). I told her you would contact her after lunch. 1 014 BOND FOR LABOR AND MATERIAL ENCROACHMENT PERMIT NO.2016-226 We,the undersigned CFEP Pruneyard,LLC ,(hereinafter"Principal")and Philadelphia Indemnity Insurance Company, a corporation organized under the laws of the State of Pennsylvania , and authorized to transact business in the State of California, as Surety, are obligated to the City of Campbell (hereinafter "City"), a municipal corporation under the laws of the State of California, in the sum of Two Hundred Thousand and 00/100 Dollars($ 200,000.00 )for the payment of which sum we obligate ourselves and our successors and assigns,jointly and severally by the following provisions: The condition of this obligation is that the Principal entered,or is about to enter,into a certain written Encroachment Permit-with the City dated January 27 120 17 , which said Encroachment Permit No.2016-226 is hereby referred to and made a part hereof. Because Principal is required to furnish a bond in connection with the Encroachment Permit,providing that if Principal,or any of its subcontractors,shall fail to pay for any materials,or other supplies,or for any work or labor on the permitted work of any kind,or for amounts due under the unemployment insurance act with respect to any work or labor on this project,the Surety on this bond will pay for the debt,in an amount not exceeding the sum specified in this bond,and also,in case suit is brought upon the bond,a reasonable attorney's fee to be fixed by the court. Now, therefore, we, CFEP Pruneyard LLC as Principal, AND Philadelphia Indemnity Insurance Company ,as Surety,are obligated to the City of Campbell,and all contractors,subcontractors,laborers, material men and other persons employed in the performance of . the aforesaid agreement in the sum of Two Hundred Thousand and 00/100 Dollars ($200,000.00 ), lawful money of the United States, for the payment of which sums will and truly to be made, we the said Principal and Surety bind ourselves, successors and assigns, jointly and severally,by these provisions. The condition of this obligation is that if Principal,its successors or assigns,or its subcontractor,or subcontractors,shall fail to pay for any labor, materials, or other supplies, used in the performance of the work permitted to be done, or for amounts due under the unemployment insurance act with respect to this work or labor,then the Surety on this bond will pay for them,in an amount not exceeding the sum specified in this bond,and in case suit is brought upon this bond will also pay a reasonable attorney's fee;to be fixed by the court. Venue for any action arising out of this obligation shall lie in the County of Santa Clara,State of California. It is expressly stipulated and agreed that this bond shall inure to the benefit of any and all persons, companies and corporations entitled to file claims under Title 15(commencing with Section 3082)of Part 4 of Division 3 of the Civil Code,so as to give a right of action to them or their assigns in any suit brought upon this bond. Should the condition of this bond be fully performed, then this obligation shall become null and void,otherwise it shall be and remain in full force and effect. No prepayment or delay in payment and no changes,extensions,addition or alteration of any provision of said Encroachment Permit or in any plans and specifications referred to herein;and no forbearance on the part of the City shall operate to release the Surety from liability on this bond, and consent to make such alterations without further notice to or consent by the Surety is hereby given, and the Surety hereby waives the provisions of Section 2819 of the Civil Code of the State of California. In witness,the parties have executed this agreement as of March 8 ,20 17 CFEP Pruneyard,LLC (Principal) y ss 1 1� 591 L i6, 6v� ' Title 9�t'.e� l�n.d 9dw�i�! off- i'1ctt�:.�rP>.✓ c,� ryY{a.w::� � r Philadelphia)ndennity Insurance Company (Surety) B g ,Attorney-In-FaZila, Adf. es of Surety:One Bala Suite 100 (Attach Acknowledgments C- nwvd.PA 19004-1403 Both Principal's and Surety's Attorney in Fact) Surety's Bond Number PB00345100046 (Accompany this bond with attorney-in-fact's authority from Surety to execute the bond,certified to include the date of the bond.) t J:\FORMS\Templates\Encroachment el"ts\Bond for Labor&Materials.doc(Rev.03108) 114 PHILADELPHIA INDEMNITY INSURANCE COMPANY One Bala Plaza,Suite 100 Bala Cynwyd,PA 19004-0950 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS:That PHILADELPHIA INDEMNITY INSURANCE COMPANY(the Company),a corporation organized and existing under the laws of the Commonwealth of Pennsylvania,does hereby constitute and appoint David G.Harris Julia Ortega,Stephanie Worden of Heffernan Insurance Brokers,its true and lawful Attorney-in-fact with full authority to execute on its behalf bonds,undertakings,recognizances and other contracts of indemnity and writings obligatory in the nature thereof,issued in the course of its business and to bind the Company thereby,in an amount not to exceed$25,000,000.00. This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14'h of November,2016. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company: (1) Appoint Attorney(s) in Fact and authorize the Attomey(s) in Fact to execute on behalf of the Company bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attomey-in-Fact and revoke the' authority given. And,be it FURTHER RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile,and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN TESTIMONY WHEREOF,PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 14T"DAY OF NOVEMBER,2016. y J........... . (Seal) Robert D.O'Leary Jr.,President 8c CEO Philadelphia Indemnity Insurance Company On this 14''day of November,2016,before me came the individual who executed the preceding instrument,to me personally known,and being by me duly sworn said that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY;that the seal affixed to said instrument is the Corporate seal of said Company;that the said Corporate Seal and his signature were duly affixed. CONN04 TN 1 prNNSnVAM . No"I Sul Non Nowud,Notary Pu01to tower NatbN Tpp.,Mcn[p County MY[p1y11{{(kfll��1WaN.B. Notary Public: residing at: Bala Cvnwvd,PA (Notary Seal) My commission expires: January 8,2018 I,Edward Sayago,Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY,do hereby certify that the foregoing resolution of the Board of Directors and this Power of Attorney issued pursuant thereto on this 140'day of November,2016 are true and correct and are still in full force and effect.I do further certify that Robert D.O'Leary Jr.,who executed the Power of Attorney as President,was on the date of execution of the attached Power of Attorney the duly elected President of PHILADELPHIA INDEMNITY INSURANCE COMPANY, —p In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this day of 20 1 a :;';;.. sue_ 192 7 = Edward Sayago,Corporate Secretary PHILADELPHIA INDEMNITY INSURANCE COMPANY yr•..+ .wti t . ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,-and not the truthfulness, accuracy, or validity of that document. State of California County of Contra Costa On wro I before me, Danielle Nicole Sage, a Notary Public (insert name and title of the officer)- personally.appeared who proved to on the basis of satisfactory evidence to be the persons) whose names) is/are subscribed-to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. DANIELLE NICOLE SAGECommission#218845t Z �� Notary Public-California z Z Contra Costa County v �] My Comm.Expires Nov 1,2018 � I" L�lSignature Seal) A notary public or other officer completing this certificate verifies only the identity of the individual who-signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA). COUNTY OF SAN FRANCISCO) ' On March 9, 2017, before me, Shawn A. Christman,Notary Public,personally appeared Melinda Ellis Evers, who proved to me on the.basis of satisfactory evidence to be the-person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity, and that by his/her/their signature on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed.the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal-. Signature [Seal] SHAWN A.CHRISTMAN" commission#206M2 z .�� Notiry.Public:Galltomia San .Expi sco County. M' Comm.Ex ites Mar 30,.2018 Annual Premium:$4,000.00 POND FOR FAITHFUL PERFORMANCE ENCROACHMENT PERMIT NO. 2016-226 We,the undersigned CFEP Pruneyard,LLC (hereinafter"Principal")and Philadelphia Indemnity Insurance Company a corporation organized under the laws of the State of Pennsylvania and authorized to transact business in the State of California, as Surety, are obligated to the City of Campbell,(hereinafter"City") a municipal corporation under the laws of the State of California,in the sum of Two Hundred Thousand and 00/100 Dollars ($ 200,000.00 )for the payment of which sum we obligate ourselves and our successors and assigns,jointly and severally by the following provisions: The condition of this obligation is: Because the obligated Principal has,on January 27 20 17 entered into written Encroachment Permit with the City for the Project, a copy of which Encroachment Permit is attached and made a part of this bond, for construction of Project 1995 S Bascom Ave(Pruneyard) Now,therefore,if the Principal shall faithfully perform the work in accordance with the plans,specifications and permit documents during the original term,and any extensions of the permit which may be granted by the City,with or without notice to the surety,and if it shall satisfy all claims and demands incurred under the permit,and shall fully indemnify and save harmless the City from all costs and damages which it may suffer by reason of failure to do so;and shall reimburse and repay the City all outlay and expense which the City may incur in curing any default,then this obligation shall be void;otherwise to remain in full force and effect, with surety obligated to secure the full and faithful performance of all of Principal's obligations under the attached Encroachment Permit. If any legal action be filed upon this bond,it shall be filed within one year after final payment has been made under the Encroachment Permit excluding the warranty period, if any,provided for in the Encroachment Permit, and venue shall lie in the County of Santa Clara, State of California, and that surety, for value received stipulates and agrees that no change, extension of time, alteration or addition to the terms of the Encroachment Permit or to the work to be performed under it or the specifications accompanying it shall in any way affect its obligation on this bond, and it does by this-means waive notice of any change, extension of time,alteration or addition to the terms of the Encroachment Permit or to the work or to the specifications,and thereby waives the provisions of Section 2819 of the Civil Code of the State of California. In witness,the parties have executed this agreement as of March 8 120 17 CFEP Pruneyard,LLC (Principal) By Title S iC,ur,tii to 1p v1Pi/ l u;s Llvl r d r a•Yv1i�:.a �y l Philadelphia lnde nity Insurance Company Z" �ttrv>nE G� (Surety) By e mey-in-Fact Ad one Bala Pla a Suite 100 Ba19004-1403 (Attach Acknowledgements) - Surety's Bond Number PB00345100046 (Accompany this bond with Attorney-in-fact's (Both Principal's and authority from Surety to execute the bond, Surety's Attorney in Fact) certified to include the date of the bond.) e, J:TORMS\Templates\Encroachmenf'Pemiits',Bond for Faithful Performance.doc(Rev.03/08) 1 113 PHILADELPHIA INDEMNITY INSURANCE COMPANY One Bala Plaza,Suite 100 Bala Cynwyd,PA 19004-0950 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS:That PHILADELPHIA INDEMNITY INSURANCE COMPANY(the Company),a corporation organized and existing under the laws of the Commonwealth of Pennsylvania,does hereby constitute and appoint David G.Harris,Julia Ortega,Stephanie Worden of Heffernan Insurance Brokers,its true and lawful Attorney-in-fact with full authority to execute on its behalf bonds,undertakings,recognizances and other contracts of indemnity and writings obligatory in the nature thereof,issued in the course of its business and to bind the Company thereby,in an amount not to exceed$25,000.000.00. This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14'h of November,2016. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company: (1) Appoint Attomey(s) in Fact and authorize the Attomey(s) in Fact to execute on behalf of the Company bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attomey-in-Fact and revoke the authority given. And,be it FURTHER RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attomey or certificate relating thereto by facsimile,and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or - undertaking to which it is attached. IN TESTIMONY WHEREOF,PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 14T"DAY OF NOVEMBER,2016. �` "Yc "`.:..,j Via ,• n �+ (Seal) Robert D.O'Leary Jr.,President&CEO Philadelphia Indemnity Insurance Company On this 14ei day of November,2016,before me came the individual who executed the preceding instrument,to me personally known,and being by me duly swom said that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY;that the seal affixed to said instrument is the Corporate seal of said Company;that the said Corporate Seal and his signature were duly affixed. C13HPIONVAALTH or.moisnyiL,411A - Houui Sul note Moore,Koury tuhnc 10 I., ne Nerloa m 1 imNOM an.a t2019 y tamimion.°fro 1/n.e,rate n.ua n•nn+•.0 uerca�o.o'+nr:o t Notary Public: residing at: Bala Cynwyd.PA (Notary Seal) My commission expires: January 8,2018 I,Edward Sayago,Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY,do hereby certify that the foregoing resolution of the Board of Directors and this Power of Attorney issued pursuant thereto on this 14"day of November,2016 are true and correct and are still in full force and effect.I do further certify that Robert D.O'Leary Jr.,who executed the Power of Attorney as President,was on the date of execution of the attached Power of Attorney the duly.elected President of PHILADELPHIA INDEMNITY INSURANCE COMPANY, p In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this © day of N UCk 20 Z�21 i " Edward Sayago,Corporate Secretary d, PHILADELPHIA INDEMNITY INSURANCE COMPANY ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of-that document. State of California County of Contra Costa On,,mn VC, 1�I --4 before me, Danielle Nicole Sage, a Notary Public , I I (insert name and title of the officer) personally appeared V �� C;( � V �00'k- who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his%her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. DANIELLE NICOLE SAGE WITNESS my hand and official seal. commission#.2088451 z ."A Notary Public-California z z Contra Costa County n My Comm.Expires Nov 1,2018 Signatur / /.� (Seal) A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA) COUNTY OF SAN FRANCISCO) On March 9, 2017,before me, Shawn A. Christman,Notary Public,personally appeared Melinda Ellis Evers,who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity,-and that by his/her/their signature on the instrument the person(s), or the:entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. Witness my hand and official seal. Signature c, [Seal] &:CHRIST_AN Cbmm130I6n#2p.62959 Not-ry PubBe:Caiitornia San Franeioeo County MY Comm.Mires Mar 30,2018 ` PUBLIC WORKS DEPARTMENT LAND DEVELOPM NT Effective July 1,2016 TO: Finance PUBLIC WORKS FILE NO. ENC 2016-'1.2•�p PROPERTY ADDRESS 1875 S Bascom Avenue(Pruneyard) Please collect&receipt for the following monies: ACCT. ITEM AMOUNT LAND DEVELOPMENT 4722 Encroachment Permit pp ica ion ee Non-Utility Encroachment Permit Major>_$10,000 $403.00 $ 403.00 Minor Encroachment Permit<$10,000 $230.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $230.00 Inspection Fee Minimum Charge per Location $398.00 Street Tree Planting/Removal N/C 2203 ($500 per Tree Planting Deposit Required) $500.00/tree 22031 Plan Check Deposit 2%of Engineer's Estimate $500.00 min $ 3,656.59 Utility and R-1 Permits no deposit required 4722 Gradinq&Drainage Plan Review Single Family Lot $281.00 Site< 10,000 s.f. $841.00 Site>_10,000 s.f.<0.5 Acre $1,127.00 Site>_0.5 Acre $1,688.00 4722 NPDES Review C3 Requirements For projects not required to submit numeric sizing $163.00 For projects required to submit numeric sizing Impervious Area 10,000 S . Ft to 1 Acre $704.00 Impervious Area 1 Acre or more $918.00 4722 For projects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities $300 ea Plan Check& Inspection Fee(Non-Utility) 4722 En r. Est.<$250,000 14%of Engineer's Estimate 4722 En r. Est.>_$250,000 and<_$500,000 $35,000+8%of Engineers Estimate 4722 En r. Est. >$500,000 $55,000+7%of Engineers Estimate 2203 Emergency Cash Deposit 4%of En r. Est.*($500 min/$10,000 Max) 2203 Faithful Performance Security FPS 100%of ENGR. EST.' 2203 Labor and Materials Security 100%of ENGR. EST.' 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 (Multi-Res$2,385.00) All Other$2,650.00 4722 Parcel Map 4 Lots or ess 4009.00+ 87 of 4722 Hnal I ract Map 5 or MoreLots) 4,871.00+ 118 of 2203 Monumentation Security 100%of Cit 's Monumentation Estimate 4920 Parkland Dedication Fee 75%/25% Due Upon Cart.of Occupancy) 4722 Lot Line Adjustment(Includes Certificate of Compliance) $1,893.00 4722 Vacation of Public Streets& Easements $2,530.00 4722 Certificate of Compliance $1,877.00 4722 Certificate of Correction $561.00 4722 Document Recording Fees $15.00/first page$3 ea.Additional 4722 Private Improvement in Public ROW $50.00 4722 Approved Plan Revision Fee $100/sheet 4722 Appeal Filing Fee $200.00 4722 Notary Fee er si nature $10.00 4722 Assessment begregation or Reapportionment First Split $895.00 Each Additional Lot $281.00 511.7424 Postage MISCELLANEOUS Other Please Specify) `Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $ 4,059.59 NAME OF APPLICANT NAME OF PAYOR �{- C PHONE C7 ADDRESS ' {r J -1 a w , ZIP FOR RECEIVE BY NOV 07 207 CITY CLERK I ONLY Date Receipt# :1 1 y r-), I�AAii >1 �/—a a }04c100 J:%Lm DevlP Chmk Cm tMl-SDe ,P,Qmtl-Alb. P-1.Prap—IB—Al 105(P1,11PId SubdiNvm�1Ftts11mace s , S9 OFCAgyE . REND BY. ebm6#G 'A = we gmGG» LLC _TO CS DATE: SZ0 4a ;SISTER DATE; GA»a «+; m:m . . +ol—I AM/ qS 3:IENC m16226 qm gRI1G. kq,m mS A= i.000 +E +rgw - !& q16569 myL qa - 1$4139,. y»qd: . CHECK «F Aw !k9 PU,'P-'-"'VORKS DEPARTMENT LAND DEVELOPIV F-"' Effective July 1,2016 TO: Finance PUBLIC WORKS FILE NO. ENC 2016-226 PROPERTY ADDRESS 1995 S Bascom Ave(Pruneyard) Please collect&receipt for the following monies: ACCT. ITEM AMOUNT LAND.DEVELOPMENT Encroachment Permit Application Fee Non-Utility Encroachment Permit Major>_$10,000 $403.00 Minor Encroachment Permit<$10,000 $230.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $230.00 Inspection Fee Minimum Charge per Location $398.00 Street Tree Planting/Removal N/C 2203 ($500 per Tree Planting Deposit Required) $500.00/tree 22031 Plan Check Deposit 2%of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 4722 Grading&Drainage Plan Review Single Family Lot $281.00 Site< 10,000 s.f. $841.00 Site>_10,000 s.f. <0.5 Acre $1,127.00 Site>_0.5 Acre $1,688.00 4722 NPDES Review(C3.Requirements) For projects not required to submit numeric sizing $163.00 For projects required to submit numeric sizing Impervious Area 10,000 Sq. Ft to 1 Acre $704.00 Impervious Area 1 Acre or more $918.00 4722 For projects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities $300 ea $ 300.00 Plan Check& Inspection Fee(Non-Utility) 4722 Engr. Est.<$250,000 14%of Engineer's Estimate $ 27,400.00 4722 Engr. Est.>_$250,000 and<$500,000 $35,000+8%of Engineers Estimate 4722 Engr. Est. >$500,000 $55,000+7%of Engineers Estimate 2203 Emergency Cash Deposit 4%of Engr. Est.*($500 min/$10,000 Max) $ 8,000.00 2203 Faithful Performance Security(FPS). 100%of ENGR. EST.* 2203 Labor and Materials Security 100%of ENGR. EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 (Multi-Res$2,385.00) (All Other$2,650.00) 4722 Parcel Map(4 Lots or Less) " $4009.00+$87/lot 4722 Final Tract Map(5 or More Lots) $4,871.00+$118/lot 2203 Monumentation Security 100%of City's Monumentation Estimate $ 10,000.00 4920 Parkland Dedication Fee(75%/25% Due Upon Cert.of Occupancy) 4722 Lot Line Adjustment(Includes Certificate of Compliance) $1,89.3.00 4722 Vacation of Public Streets&Easements $2,530.00 4722 Certificate of Compliance $1,877.00 4722 Certificate of Correction $561.00 4722 Document Recording Fees $15.00/first page$3 ea.Additional 4722 Private Improvement in Public ROW $50.00 4722 Approved Plan Revision Fee $100/sheet 4722 Appeal Filing Fee $200.00 4722 Notary Fee'(per signature) $10.00 4722 Assessment Segregation or Reapportionment First Split $895.00 Each Additional Lot $281.00 511.74241 Postage MISCELLANEOUS.. Other(Please Specify) Green Bike Lane$50k/Traffic Equipment$40k1Feasbility Study$45k Non Refundable $ 135,000.00 10 j `Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. _TOTAL $ 180,700.00 NAME OF APPLICANT Dean Rubinson, Ellis Partners/HMH Engineers NAME OF PAYOR CFEP PRUNYARD LLC PHONE5_0` :5 15 3%11 800 ADDRESS 111 Sutter Ave Suite#800, San Francisco ZIP 94104 FOR RECEIVED.BY ITY CLERK � ._... .� wc 'R � G.�._ ONLY -- Date Receipt# e. PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT Effective July 1,2016 TO: Finance PUBLIC WORKS FILE NO. ENC 2016- PROPERTY ADDRESS 1875 S Bascom Avenue(Pruneyard Please collect&receipt for the following monies: ACCT. ITEM AMOUNT LAND DEVELOPMENT 4122 Lncroachment Hermit Application ee Non-Utility Encroachment Permit Major>_$10,000 $403.00 $ 403.00 Minor Encroachment Permit<$10,000 $230.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $230.00 Inspection Fee Minimum Charge per Location $398.00 Street Tree Planting/Removal N/C 2203 ($500 per Tree Planting Deposit Required) $500.00/tree 2203 Plan Check Deposit 2%of Engineer's Estimate $500.00 min $ 3,656.59 Utility and R-1 Permits no deposit required 4722 Grading&Drainage Plan Review Single Family Lot $281.00 Site< 10,000 s.f. $841.00 Site_> 10,000 s.f.<0.5 Acre $1,127.00 Site>0.5 Acre $1,688.00 4722 NPDES Review(C3 Requirements For projects not required to submit numeric sizing $163.00 For projects required to submit numeric sizing Impervious Area 10,000 Sq. Ft to 1 Acre $704.00 Impervious Area 1 Acre or more $918.00 4722 For projects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities $300 ea Plan Check& Inspection Fee(Non-Utility) 4722 Engr. Est. <$250,000 14%of Engineer's Estimate 4722 Engr. Est.>_$250,000 and<$500,000 $35,000+8%of Engineers Estimate 4722 Engr. Est. >$500,000 $55,000+7%of Engineers Estimate 2203 Emergency Cash Deposit 4%of Engr.Est."($500 min/$10,000 Max) 2203 Faithful Performance Security FPS 100%of ENGR. EST.' 2203 Labor and Materials Security 100%of ENGR. EST.` 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 _ (Multi-Res$2,385.00) (All Other$2,650.00) 4722 Parcel Map 4 Lots or Less 4009.00+ 87 lot 4722 Final Tract Map 5 or More Lots 4,871.00+ 118/lot 2203 Monumentation Security 100%of Cit 's Monumentation Estimate 4920 Parkland.Dedication Fee 75%/25%*Due Upon Cert.of Occupancy) 4722 Lot Line Adjustment(Includes Certificate of Compliance) $1,893.00 4722 Vacation of Public Streets&Easements $2,530.00 4722 Certificate of Compliance $1,877.00 4722 Certificate of Correction $561.00 47221 Document Recording Fees $15.00/first page$3 ea.Additional 4722 Private Improvement in Public ROW -$50.00 4722 Approved Plan Revision Fee $100/sheet 4722 Appeal Filing Fee $200.00 4722 Notary Fee per signature) $10.00 4722 Assessment begregation or Reapportionment First Split $895.00 Each Additional Lot $281.00 511.7424 Postage MISCELLANEOUS Other(Please Specify) `Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $ 4,059.59 NAME OF APPLICANT r NAME OF PAY OR PHONE qJ15I "/ v ADDRESS i` Lh, ,;:. ;,. ZIP ,,., .,.its• — r, FOR RECEIVEI/BY CITY CLERK ONLY ID ate Receipt# }� �l' OV CA41 _ JoAnna T Pon A ld� • Office Specialist r, City of Campbell U rr Department of Public Works ° ° 70 North First Street A 1 F c� Campbell,CA 95008 • k C H A R Phone:(408)866-2150 E-Mail:Joannat@cityofcampbell.com Transmittal To: Dean Rubinson Date: 4/4/17 Company:Ellis Partners Re: Deposit Refund- Permit#ENC2016-226 ❑ Urgent ❑ For Review ❑ Please Comment ❑ Please Reply ❑ For Information&Use Please find enclosed a check in the amount of$200,000.00 representing the deposit refund we are issuing for the exchange of the Faithful Performance and Labor/Material Bonds(#20PB00345100046). Sincerely,, JoAp1na T ason Of ist e Specia r cc: Doris Quai Hoi Enc: Check#261837 J:\JoAnnaT\Deposit refundslettersWisc deposits\Pruneyard Bond Exchange.doc ....................._............__, ......._............._........_....; _............._............... ; .....__........._..............> i................................_: t............................_._...... i c.._............................ i.._......_.............: ' CITY OF CAMPBELL, VENDOR NO. 10013873 CHECK No. 261837 AV fee Number.. :.......'Amou escrip 101 2203 CR032217 200,000.00 ENC2016-226 PRUNEYARD 10013873 CFEP PRU_NEYARD LLC i ' I - - - i I J CITY Q� CAMPBELL HECK DATE CHECK NO I r WE1 G$ FARGO HANK N A 11 24 NOR'T•H FIRST STREET .. 4�4 MONTGOh1ERY STREET 1210 3 7 a SAN FRANCISCO CA 94104 : '�, s - t L r" CAMPBELL CALIFORNIA 96008 0,0, 0 0 0 0 DY,' o �ko1cAR�''G VOID AFTER 90 DA�S 0II t o y PAY THE SUM OF TWO HU�TDRED. THOUSAND :DOLLARS & ZERO CENTS"% mI 3 N: TO THE CFEP' PRUNEYARD,:LLC OF' ` nP. SAN FRANCISCO CA 94612 _ .����' � � En' 26 :'LS'37u■� �.:1 2 L�000 248ri �: L 2rL85.54 L5u■ ;�_. ----- , - 1 ---- / 1 / /• 1 1 1-"---_-- -----"- _ -• - 1------/---'--1--- 1 --' —___ ._.._.__-.:_�� ..........._..,....._. .................._._._............ _...................; - - ...- 1...._..._........._..-,_._.._ - -...__......... : f r *See Reverse Side For Easy Opening Instructions* CITY ,OF CAMPBELL 70 NORTH FIRST STREET' CAMPBELL, CALIFORNIA 95008 _ I CFEP PRUNEYARD LLC 111 SUTTER, SUITE 800 SAN FRANCISCO CA 94612 i ................................. .............. .............. ............ ...... ---- - -- - ----------------- - ---- - ---- ---------------------- -- ------ - -------- I CITY OF CAMPBELL VENDOR NO. .10013873 CHECK NO. 271034,' ...... ............................ ................. .. ............................... ............. ....... ...................hon .....-.............................: q.. . ..... ... ................ ....................................... X ql. .................. ........... .................... .... ........... .........I......... I.Pua r: :':-:::-:JfiV&f& .um ................ 101 2203 � CR120318 3,6SG.S9 ENC2016-226 PRUNEY4kD Ir 10013873 CFEP PRUNEYARD LLC ;k CHECK DATE' CHECK NO.* 11-24 OfCAlVIPBELL 9*.iFAtRG0 BANK, N.A. STREET t/18 a9�,�IONTGOMERY.STREET -172-1 12/10 —0 271034 FRANCISCO, CA 94104 .j:.. CAMPBELL.: CALIFORNIA 95008 0- -6 59*AMOUNT Ol 4i, o ;i:WOID AFTER.90 DAYS:, RAY THE SUM OF THREE THOUSAND, SIX ,HUNDRED FIFTY SIX DOLLARS & 59 cl) CENTS' IS TO.,THE CFEP PRUNEYARD LLC ORDER 11,1• SUTTER; SUITE.800 . ........ 7w SAN FRANCISCO CA 94612 27 10 3 411 L-2 1000 24 Blm' .21 S ll� L S 110 1:10 1111261 lRel fallej AL --------- ----- - ------ - - ---- -------------- -- -- ---------------------------------------- ............... .............. ----------------------- ....................................... ...................................... ........................................ ............................. L...................................... ......................................... ...............:7 *See Reverse Side Fo(r Easy Opening Instructions* ---------- CITY OF CAMPBELL -7'0 NORTH FIRST STREET CAMPBELL, CALIFORNIA .95008 II CFEP PRUNEYARD LLC 111 SUTTER, SUITE 800 SAN FRANCISCO CA 94612 SOLD BY. MILPITAS MATERIALS COMPANY WEIGHED/ AT:1125 N. MILPITAS BLVD. MILPITAS, CA 95035 ' ' r i ' =° PHONE: 408-262-0656 510-656-2619 650-969-4401 TRUCK# DRIVER FAX: 408-942-0826 WE MAKE ALL DELIVERIES INSIDE CURB AND ON LOT AT CUSTOMERS RISK ONLY TIME LOADED AND ACCEPT NO RESPONSIBILITY FOR DAMAGES RESULTING FROM SUCH DELIVERY. . ' IT IS CUSTOMERS RESPONSIBILITY TO HANDLE THESE MATERIALS SAFELY AND ARRIVE JOB PROPERLY. �f y�� r� 4,� V WARNING: Materials are irritating to the skin and eyes because they contain Portland Cement,so wear rubber boots and START POUR gloves. Prolonged contact may cause burns. Avoid contact with eyes and prolonged contact with skin. In Case of contact with skin or eyes flush thoroughly with water. If irritation persists,get medical attention. Precaution must be observed because alkali burns occur with little warning and little heat is sensed. END POUR WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weighmaster,whose signature is on this certificate,who is a recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code, ARRIVE PLANT administered by the Division of Measurement Standards of the California Department of Food and Agriculture. WATER ADDED AT JOB: GALLONS MILPITAS MATERIALS CO. DEPUTY WEIGHMASTER CUSTOMER ID PHONE NUMBER JOB/P.O.NUMBER TDATE TICKET SOLD TO DELIVER TO l.J 'y' :� 1.: :)li., '�.l'. l• ut � �::,,�,. ... R'ilcir :l.il'`i LOAD# SLUMP QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE el .':I,I f:');�- I- , •( l.:�`, i . ..,l'i... .a,"C.i t'r.r...i ... �•�{ri .. .. ,'i(.l , �_'.i!' i ,i'ii Ali.:li .. 7.1, i'.. ., STAND BY TOTAL MINUTES ALLOWED MINUTES CHARGED MIN TE SUB TOTAL CHARGE @' `" r``s'/MINUTE SALES TAX If buyer fails to pay the amount owed when due,buyer agrees to pay monthly service charges equal to 11 2%per month (18%per annum)of the outstanding balance of principal due as liquidated damages. A SERVICE CHARGE of$20 will be charged on any returned check. Necessary ATTORNEY FEES,COLLECTION AND SUIT COSTS will be STAND BY charged on any unpaid bills. Milpitas Materials will not be held liable or responsible for the removal or replacement of any material once it is accepted and placed at the'obsite. OTHER e�ri+�wcr� ov. TOTAL L + SOLD BY: MILPITAS MATERIALS COMPANY WEIGHED/ MEASURED AT:1125 N. MILPITAS BLVD. MILPITAS, CA 95035 i PHONE: 408-262-0656 510-656-2619 650-969-4401 TRUCK# DRIVER FAX: 408-942-0826 WE MAKE ALL DELIVERIES INSIDE CURB AND ON LOT AT CUSTOMERS RISK ONLY TIME LOADED AND ACCEPT NO RESPONSIBILITY FOR DAMAGES RESULTING FROM SUCH DELIVERY. IT IS CUSTOMERS RESPONSIBILITY TO HANDLE THESE MATERIALS SAFELY AND ARRIVE JOB__ PROPERLY. r) ;3- WARNING: Materials are irritating to the skin and eyes because they contain Portland Cement,so wear rubber boots and START POUR gloves. Prolonged contact may cause burns. Avoid contact with eyes and prolonged contact with skin. In case of contact with skin or eyes flush thoroughly with water. If irritation persists,get medical attention. Precaution must be observed because alkali burns occur with little warning and little heat is sensed. END POUR ' WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weighmaster,whose signature Is on this certificate,who is a recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code, ARRIVE PLANT administered by the Division of Measurement Standards of the California Department of Food and Agriculture. WATER ADDED AT JOB: GALLONS MILPITAS MATERIALS CO. I ; DEPUTY WEIGHMASTER CUSTOMER ID PHONE NUMBER JOB/P.O.NUMBER DATE TICKET SOLD TO DELIVER TO i. l._, . 1'` LOAD# SLUMP QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE J. _...'.r STAND BY TOTAL MINUTES I ALLOWED MINUTES CHARGED MINUTES SUB TOTAL CHARGE @ ''•'%MINUTE IT—buyer fails to a the amount owed when due,buyer agrees to a month) service charges equal to 11/2%per SALES TAX pay Y 9 pay Y 9 q month (18%per annum)of the outstanding balance of principal due as liquidated damages. A SERVICE CHARGE of$20 will be charged on any returned check. Necessary ATTORNEY FEES,COLLECTION AND SUIT COSTS will be STAND BY charged on any unpaid bills. Milpitas Materials will not be held liable or responsible for the removal or replacement of any material once it is accepted and placed at the'obsite. OTHER QCn1=1\/G11 QV• TOTAL Y4 SOLD BY: MILPITAS MATERIALS COMPANY ME SUREDAT:1125 N. MILPITAS BLVD. MILPITAS, CA 95035 a o-, , PHONE: 408-262-0656 510-656-2619 650-969-4401 TRUCK# DRIVER FAX: 408-942-0826 WE MAKE ALL DELIVERIES INSIDE CURB AND ON LOT AT CUSTOMERS RISK ONLY TIME LOADED AND ACCEPT NO RESPONSIBILITY FOR DAMAGES RESULTING FROM SUCH DELIVERY. IT IS CUSTOMERS RESPONSIBILITY TO HANDLE THESE MATERIALS SAFELY AND ARRIVE JOB PROPERLY. WARNING: Materials are irritating to the skin and eyes because they contain Portland Cement,so wear rubber boots and START POUR gloves. Prolonged contact may cause bums. Avoid contact with eyes and prolonged contact with skin. In case of contact with skin or eyes flush thoroughly with water. If irritation persists,get medical attention. Precaution must be observed because alkali bums occur with little warning and little heat is sensed. END POUR WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weighmaster,whose signature is on this certificate,who is a .� •t recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code, ARRIVE PLANT administered by the Division of Measurement Standards of-the.California Department of Food and Agriculture. WATER ADDED AT JOB: MILPITAS MATERIALS CO. i GALLONS DEPUTY WEIGHMASTER CUSTOMER ID PHONE NUMBER --- " J08/P.O.NUMBER DATE TICKET SOLD TO DELIVER TO j.r;i. `.� t"•i';t ( i .j LOAD# SLUMP I :ll..!. 1 ,f'fi QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE I17''Ill� 1 t is�i,n {. ., STAND,'BY TOTAL MINUTES ALLOWED MINUTES CHARGED MINUTES SUB TOTAL CHARGE 9 '' �j11'%MINUTE I bu er fails to a the amount owed when due,buyer agrees to a monthly service charges equal to 11 2%per SALES TAX Y PY Y 9 PY Y 9 q month (18%per annum)of the outstanding balance of principal due as liquidated damages. A SERVICE CHARGE of$20 will be charged on any returned check. Necessary ATTORNEY FEES,COLLECTION AND SUIT COSTS will be STAND BY charged on any unpaid bills. Milpitas Materials will not be held liable or responsible for the removal or replacement of anV material once it is accepted and placed at the'obsite. OTHER r+`r` TOTAL L9:r-F:1x11=n Rv Jl�/ e Al WBUTLER , .._. , i Construction, 1 Project:'Pr>�u � Phase Location: 1875 Bascom Ave., Campbell, CA 95008 Submittal Item:=;�. a"' a �llllieIllr�' Submitting Company: BrightView Landscape Services, Inc. Date Submitted: 3/16/17 Please Review by: 3/20/17 Checklug to mly for ienarcl �x,.,a<, ra vilb too donkin r Ge t ch tho ,pro'o,i cad gnnorai •-, r:^ta thn givon In this Cont_mt r;G-ameatta, ic to the regi'Aee- f u aailt's G. t:10 D"IV.... .. The mattrc-try= ttt mans " €; b'D oarrhmed t and con,-a P'T at t'.e V- L. cT° 45shr3�trds� 4'A constricitars. coov1saa6w cf nw ,raafx nth t'Est C! 01 oth q Alec, and the Gatisf0tiosy of 1110 wort.BY A QIA 3 (� ►�- CITYaITY. REVIEWED W. L. BUTLER CONSTRUCTION, INC. -� BY: Camilo Escamiila RATE: 3(16/17 �����AT-C.- ; This is a general review only and does not constitute a J detailed check of dimensions, quantities, materials, CITY ' fabrication or methods. This review shall not relieve the subcontractor, sub-subcontractor or vendor from conforming with all the aspects of the Contract Documents and neither the Contractor, Architect nor Owner shall be held responsible for any errors or omissions by reason of this review. JOB 11 26522 VWLB SUBM 9 2.1 T ENTERPRISES, INC. ME IN BUSINESS SINCE 1961 To: BrightView Landscape Services Job Ref: The Pruneyard Certificate of Compliance for Biotreatment Soil Mix I hereby certify that the Biotreatment Soil Mix, to be delivered to the project cited above from our company, meets the "Soil Specifications" criteria in sections 1-4 on pages L-1 to L-4 of .Attachment L of the San Francisco Bay Regional Water Quality Control Board's Municipal Regional Stormwater Permit (MRP) adopted on November 28, 2011, with the exception of the following minor deviations; bulk density, moisture content, and particle size analysis of the compost component at this time. A copy of this Certificate of Compliance will be provided with the delivery of the soil mix. Our test results have been conducted within 120 days prior to the delivery date of the biotreatment soil mix to the project site. Thank You, Signed: Name: Matt Moore Title: Operations Manager Contact email address: matt(?,tmtenterprises.net Contact phone number: 408-432-9040 1996 Oakland Road ♦ San Jose,CA 95131 Phone:408-432-9040 ♦ Fax:408-432-9429 T ENTERPRISES, INC. IN BUSINESS SINCE 1961 To: BrightView Landscape Services Subject: BASMAA Submittal Package There is currently one issue with Attachment C in the current submittal package, all relating to the compost used in the mix: 1. The sieve data is not fully compliant. percent passing 1/4" exceeds specified limit. We monitor every commercial compost operation within 100 miles, on a monthly basis. None are fully compliant at this time. We are using the best available compost at this time. Please let me know if there are any further questions or concerns. Sincerely, Matt Moore Operations Manager 1996 Oakland Road ♦ San Jose,CA 95131 Phone:408-432-9040 ♦ Fax:408-432-9429 Attachment A Supplier Analysis of Biotreatment Soil Mix The table below shall be completed by the Biotreatment Soil Mix Supplier. � �h OM. ° 3 J. �� Date: Name of Person Filling Out This Form: 2�23�� Matt Moore (All lab tests must be done within the last 120 days) Title: Signature: Operations Manager Phone: Email: 408-432-9040 matt@tmtenterprises.net Company Name: City: TMT Enterprises, Inc San Jose Street Address: Zip: 1996 Oakland Rd. 95131 I certify that the provided Biotreatment Soil Mix meets the ❑■ Yes (Pass) requirements of the BASMAA Regional Biotreatment Soil Specification (2016). ❑ No(Fail) Describe the equipment Materials are measured out on a clean asphalt pad, tumbled and methods used to mix With a front-end loader, then run through a mechanical the compost and sand shredder/mixer for a final homogeneous blend, free of lumps components of the and clods of compost. Biotreatment Soil Mix. Material Standard Percent(by volume) Actual Mix% Pass Fail Sand 60%-70% 60 0 ❑ Compost 30%-40% 40 0 ❑ ❑■Does the soil mix have a permeability of at least 5 inches per hour?' Yes (Pass) ❑ No (Fail) Will the soil mix support vigorous plant growth? ❑■ Yes (Pass) ❑ No (Fail) ° a , n li 'Soil mix permeability testing is only required for alternative biotreatment soil mixes. Soil permeability tests must be conducted on a minimum of two samples using constant head permeability in accordance with ASTM D2434 with a 6-inch mold and vacuum saturation. Attachment A Page 1 of 1 5/27/2016 Attachment B Lab Analysis of Sand Component of Biotreatment Soil Mix The table below shall be completed by the laboratory conducting the sand analysis. Name of Person Filling Out This Form: Signature: � I C- (S_6 t'_�E:�a �4� Title: Date: C -'�t.c_1+ 2 - 7-7 �,O 1 m7 Phone: Email: Company: City: De-s%1 V.6 An r-CIAes Street Address: Zip: Qualifications&relevant certifications(ASTM, CTM or approved equivalent certifications): Is sand free of wood,waste,coating(such as clay,stone Yes(Pass) dust,carbonate,etc.),or any other deleterious material? ❑ No(Fail) Is all aggregate passing the No.200 sieve non-plastic? Yes(Pass) ❑ No (Fail) Particle size analysis shall be conducted in accordance with ASTM D 422(Standard Test Method for Particle Size Analysis of Soils)or CTM 202.Other equivalent methods acceptable only if approved. Sieve Size Standard Percent Passing(%by weight) Testing Results(%) Pass Fail 3/8 inch 100% C>.11 No.4 90%-100% Ito [9 ❑ No.8 70%-100% 9 ❑ No.16 40%-95% q ❑ No.30 15%-70% �j 0� ❑ No.40 or ®� ❑ 5%-55% 50 1 t No. 100 0%-15% �jj ❑ No.200 0%-5% ` ❑ Attachment B Page 1 of 1 5/27/2016 Attachment C Lab Analysis of Compost Component of Biotreatment Soil Mix The table below shall be completed by the laboratory conducting the compost analysis. ��f;�:vwaraxa ° .._e. .�^sev S«x, ,xs�.. ��;;..�,. .�.,., ;.�:'v34 "i#:r ,.Ma:� ,x ,,,Tw„„�," cmwa;.a mt�.< ,,aY+ ,'u'^,,.L:+ `��✓au.3� �«�%'�d' " �uw*'��I'- Name of Person Filling Out This Form: Signature: Assaf Sadeh 0 Title: Compost Analyst Date: 3/2/17 Phone: 831-724-5422 Email: asadeh@controllabs.com Company: Soil Control Lab City: Watsonville Street Address: 42 Hangar Way Zip: 95076 Qualifications&relevant certifications: (STA,ASTM or approved equivalent certification) STA Specification,' ti ,aStanclard= Testing Results Pass', Fail , Organic Matter Content 35%-75% 58.5 (by dry weight) Carbon-to-Nitrogen Ratio 15:1 to 25:1 (C:N) 24 C:N ® ❑ Salinity <6.0 mm hos/cm 3.6 mm hos/cm ® ❑ PH 6.2- 8.2 8.18 pH ® ❑ Bulk Density 500— 1100 dry Ibs/yd3 594 dry Ibs/yd3 ® ❑ Moisture Content 30%-55%(of dry solids) 49.8 % ® ❑ Percent inert ingredients < 1% ® El 0.5 (incl. plastic,glass, paper) (by weight or volume) Provide the results of at least one'of the following prialyses,to indicate compost,-stability: Specification Standard, . Testing�Results Pass °Fail Oxygen Test < 1.3 02/unit TS/hr 02/unit TS/hr ❑ ❑ Specific Oxygen Test < 1.5 02/unit BVS/hr 02/unit BVS/hr ❑ ❑ Respiration Test <8mg COZ-C/g OS/day 5.7 mgCO2-C/9 OS/day ® ❑ Dewar test <20°C Temp. rise e. °C Temp. rise e. ❑ ❑ Solvita® Index value >5 Index value Index value ❑ ❑ � S B ex ', � v e1r F"vgk�v� �,4" ✓ . v,� Attachment C Page 1 of 2 5/25/2016 � y,.. � &a %re&` 3w�`�; ' 1"� „ ? 7 4 ���& iSit�� IGPr�;a" r� '✓%, "''.i*.e�* d� , ± '' � �s,'+a 7 k ,� ve Provide the results'of at least"one°'of'the°.following analyses to indicate compost toxicity': " Specification Standard Testing.Results Pass Fail - Ratio of NH4+: NO3-N <3 NH4+: NO3-N ❑ ❑ Ammonium <500 ppm, dry basis 33 ppm, dry basis ® ❑ Seed Germination >80%of control 100 %of control ® ❑ Plant Trials >80%of control 116 %of control ® ❑ Solvita® Index value =5 Index value Index value ❑ ❑ ry as 9 �q��' �§ f rl" ✓r t .fix t ..".�., gn a ,ek".7r,.�% ." ,'r. ,.�.`b«, Provide the analysis of tfie riutrient,content of-the cornpost includingthe following. Specification, pecification Standard Testing Results> Pass Fail" Boron (total,in ppm) <80 ppm 23 ppm ® ❑ Nitrogen (N)(total%) >0.9% preferred. 1.2 % " Phosphorus(as PZOs) [not specified] 0.47 Potassium (as K20) [not specified] 0.77 % Calcium (Ca) [not specified] 1.7 % Sodium (Na) [not specified] 0.16 Magnesium (Mg) [not specified] 0.44 g Sulfur(S) [not specified] 350 ppmK ryr nil Provide the-results of at-least oneof the following select pathogens Specification Standard Testing°Results Pass. '`Fail x Salmonella <3 MPN/4 grams TS <3 MPN/4 grams TS ® ❑ Coliform Bacteria < 10,000 MPN/gram MPN/gram ❑ ❑ All ,aalt. . F, zma'�„,..ks+r ,.•; `„P.�4rt.,".�r�1+Ms ., 9 a z " Does the product meet US EPA,40CFR 503 regulations regarding trace ® Yes(Pass) contaminants metals (Lead, Mercury, etc.)? ❑ No(Fail) Particle size;analysis.shail be,co,nducted in,accotdance with ASTM p,„422,{Standard Test Method for Particle'Size"An'alysis ofSoils)-washing not `required: Equivalent methods acceptable,if approve"cl Sieve;Size Standard..Percent Passing(by weight) „Testing Results(%); Pass,,Pass,j Fail 1 inch 99%-100% 100 ® ❑ inch 90%-100% 100 ® ❑ inch 40%-90% 97.5 ❑ No. 200 1%-10% 3.4 ® ❑ � ` b s 5, i MINIM` �� r'�`. a .a �, � Attachment C Page 2 of 2 5/25/2016 4 �r x' 3 S f Attachment D Supplier Analysis of Compost Component of Blotreatment Soil Mix The table below shall be completed by the Compost Supplier providing the compost for the mist Name of Company:P y: Date of Delivery: Qualiffcations&relevant certifications: Date of the Compost Lab Analysis R"ert:'1 (STA,ASTM or approved equivalent certifications) (Must be dated within 120 days prior to cf8 <57A_ ,312 00 7 Name of person filling Out This Form: Date: Signatur Street Address: Email addr ss: City: / Phone: Zip: y 3 r—: Feedstock materials have been specified and include only the following: (F' � Landscape/yard trimmings,grass clippings,food scraps,or agricultural crop residues? Compost has a dark brown color and a soil-like odor,does not exhibit a sour or putrid Yes smell,does not contain recognizable grass or leaves,and is not hot(1207)upon s. delivery or reweriing? to > 4 ss__ vaM. Ali Ew.,z, s. The compost has gone through the process to further reduce pathogens(PFRP)? For example, turned windrows must reach a minimum temperature of 55'C for 15 days with at least 5 turnings during that period. x Y ;T, 3/31/2014 attachment D Page 1 of 1 CITY OF CAMPBELL RECVD BY: CASHIER 01000270558 PnYOR: JEFF WILLIAMS TOTAY'S DATE: 071119/17 REG18TER DATE: 07/19/17 TIME: 00:00 DESCRiP T IOC# AMOUNT OUST !D:ENC2015-00226 ENGR R SUP51V FILING F $ 00.00 ---------------- TOTAL DUE: $500.00 TENDERED: $500.00 CHANGE: $.00 CREDIT CARD: $500.00 REF NUM: CUSTOMER COPY PUBLIC WORKS DEPARTMENT LAND DEVELOPMENT V • Effective July 1,2017 ✓��� TO: Finance PUBLIC WORKS FILE NO. ��( PROPERTY ADDRESS © S. Please collect&receipt for the following monies: ACCT. ITEM AMOUNT LAND DEVELOPMENT 4722 Encroachment Permit Application Fee Non-Utili Encroachment Permit Ma'or>_$10 000 $425.00 Minor Encroachment Permit<sio,000 $240.00 Initial R-1 Permit N/C Subsequent R-1 Permits within Two Year Period $240.00 Inspection Fee Minimum Charge per Location $420.00 Street Tree Plantinq/Removal N/C 2203 ($500 per Tree Planting Deposit Required) $500.00/tree 2203 Plan Check Deposit 2%of Engineer's Estimate $500.00 min Utility and R-1 Permits no deposit required 4722 Grading&Drainage Plan Review Single Family Lot $295.00 Site< 10,000 s.f. $885.00 Site>_ 10,000 s.f. <0.5 Acre $1 185.00 Site>_0.5 Acre $1 772.00 4722 NPDES Review C3 Requirements) For projects not required to submit numeric sizing $175 00 For projects required to submit numeric sizing Im ervious Area 10,000 S . Ft to 1 Acre $740.00 Impervious Area 1 Acre or more $965.00 4722 For projects sent to Consultant for review Consultant Cost+20% 4722 Additional treatment facilities $315 ea Plan Check& Inspection Fee Non-Utility) 4722 En r. Est. <$250 000 14%of Engineer's Estimate 4722 Enqr. Est.>_$250,000 and<_$500,000 $35,000.00+8%of En- ineers Estimate 4722 En r. Est. >$500 000 $55 000.00+7%of Engineers Estimate 2203 Emergency Cash Deposit 4%of En r. Est.*($500 min/$10,000 Max 2203 Faithful Performance Security FPS 100%of ENGR. EST.* 2203 Labor and Materials Security 100%of ENGR. EST.* 4721 Storm Drainage Area Fee Per Acre R-1 $2,120.00 (Multi-Res$2,385.00) (All Other$2,650.00) 4722 Parcel Ma (4 Lots or Less) $4,200.00+$90/lot 4722 Final Tract Map(5 or More Lots) $5 115.00+$124/lot 2203 Monumentation Securit 100%of Cit 's Monumentation Estimate 4920 Parkland Dedication Fee(75%/25% Due Upon Cert. of Occupancy) 4722 Lot Line Adjustment(Includes certificate of Compliance) $1,990.00 4722 Vacation of Public Streets&Easements $2,700.00 4722 Certificate of Compliance $1,970.00 4722 Certificate of Correction $590.00 4722 Document Recording Fees $15.00/first page$3 ea.Additional 4722 Private Improvement in Public ROW $100.00 47221 Approved Plan Revision Fee $100/sheet ` 4722 Appeal Filing Fee $200.00 730.4924 Notice of Improvement Obligation Payment 4722 Assessment egregation or Reapportionment First Split $940.00 Each Additional Lot $295.00 511.7424 Postage MISCELLANEOUS Other(Please Specify) *Engineer's Estimate shall be as approved by the City Engineer and shall include all items of work. TOTAL $ " NAME OF APPLICANT JJ NAME OF PAYOR PHONIP A I I ADDRESS ZIP JULN (( FOR RECEIVED BY -ol l Y OF CAMPBEIA CITY CLERK �,n ONLY Date Recei t# J'TORMMTempla Matr*Scope Engineering Laboratories, Inc. pY June 1,2017 DSA File #: DSA Appl. #: DSA/LEA #: 138 Matt Weber ORS OSHPD #: Ellis Partners, Inc. MEL File #: 2570 111 Sutter Street, #800 San Francisco, CA 94104 Subject: Weekly Special Inspection and Material Testing Summary Report Doubletree by Hilton Hotel Facility Improvements 1995 South Bascom Avenue, Campbell, CA Week Ending: May 28, 2017 Dear Matt, MatriScope Engineering Laboratories, Inc. (MatriScope) is performing special inspections and/or material testing services during construction of the subject project. Daily field reports have been prepared by the individual(s) who completed requested services and are attached to this report for the time period specified above. In order to improve the future closeout process and enhance construction quality assurance, this letter also summarizes any open items contained in our records related to either work requiring re-inspection or non-conforming work requiring corrective action. The attached daily field reports have been reviewed by our staff and any documented open items contained in our records will require specific attention in order.to assure correction of each issue and timely project closeout. This may include scheduling of re-inspection(s) or submitting a Request-for- Information (RFI) to the engineer of record to verify the construction variance observed is acceptable or additional actions necessary to correct deficiencies. It is the contractor's responsibility to complete the project in accordance with the approved project plans and specifications. Online access to your project documents is available through MatriScope's cloud-based ShareFile program. Should you have any questions or require additional information please contact our corporate office in Sacramento at (916) 375-6700 or Livermore Office at (925) 606-7700. Respectfully S mittecl, MatriScope ginee g ab ories, Inc. Ying= i Lia ;G.E., C. S'enlo Engineering M nager Attachment: Daily Field Reports List of open items(if applicable) cc: Project Distribution List 601 Bercut Drive•Sacramento,CA 95811 • 916.375.6700 1 6244 Preston Avenue•Livermore,CA 94551 •925,606.7700 MatriScope June 1, 2017 aa' r MEL File # 2570 ryp..Engineering Laboratories,Inc. j0p Special Inspection and Material Testing Services Open Items/Non-Conformance Reminder Doubletree by Hilton Hotel Facility Improvements 1995 South Bascom Avenue, Campbell, CA Report Date Reported By Non-Conformance 5/2/2017 Shah B Compaction at sidewalk failed in two locations Reinspect 601 Bercut Drive•Sacramento,CA 95811 • 916.375,6700 / 6244 Preston Avenue•Livermore,CA 94551 -925.606.7700 6745u - u rip GO,PBERCUT DRIVE•,SA'tRANIENT0 CA%95811 PH.916.606.7700 r� LIVERFAORE CA',94551 PH.925.606.7700 ®e M GLt�°7 /�Oy y p p ;Cq,,94612 PH,510.763.3601 1 V p e 62M1 i�tiESTON AVENi 29' OAKtJ1N i 436'I •STREET,SUITE.. ;+ Engineering Laboratories, Inc. PERMIT NO.: BLDG.NAME: D5A/OSHPD FILE NO.: _ DSAAPPL./OSHPD FACILITY NO.: 138/2.89 ,• DSA LEA NO.: _ DSA BLDG.NO.: DSA CARD NO.: t_ - REPORT IZ10.: DAILY FIELD REPORT PROJECT NAME: ; d MELJOB NO: JOB/SHOP ADDRESS: — `-. M T W TH IF SA SU DATE: PAGE NO.: of NAME OF FABRICATOR,BATCH PLANT,ETC: Arrival Time: I�PM Overtime ❑ Re-Inspection ❑ Non-Conformance ❑ TYPE OF INSPECTION: �R Earthwork, ❑ Rebar,❑Concrete, ❑Masonry, ❑Shop Fabrication,❑Welding, ❑ Material ID,❑ Batch Plant, ❑PT Concrete,Q.Epoxy/Wedge Anchors/Dowels,❑ Pull/Torque Testing, ❑Fireproofing,❑Waterproofing,❑KS, Bolting;❑Metal Decking;,[]Other: MEL TASK CODE: "a„\ EQUIPMENT USED: DOCUMENTS REFERENCED: SUMMARY: Ica, Material Sampled/Tested: i Qty,of Samples: Location(s)Sampled: Compliance Statement: 1. The work C Was/❑ Was Not Inspected In accordance with the requirements of the approved❑ DSA 10 OSHPD project documents. 2. The work inspected IL Met/0 Did Not Meet the requirements of the approved LJ DSA/❑ OSHPD project documents. 3, Material Sampiing approved❑ Was/❑Was Not performed in accordance with the approved❑ DSA/❑ OSHPD project documents. SITE REPRESENTATIVE NAME: INSPECTOR(PRINT):.C;>Z,.�gN — COMPANY/TITLE: CERTIFICATION NO.: REPORT PROVIDED E-MAIL: SIGNATURE: 'NOTE:Signature of the site representative verifies that the MEL Inspector was present on-sire and does not Indicate acceptance of the work,report;or test resufts. CC:❑DSA/I]OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:09101/1S << Io MatriScope DAILY COMPACTION TEST *�e m 6016ERCUT DRIVE• SACRAMENTO• CA,95>;11 PH 91b.375.6700 ROO; Engineering Laboratories,Inc. REPORT 6244 PRESTON AVENUE • LIVERMORE CA,94551 PH.925.606,7700 �rPn• 436 14°STREET,SUIFE 14Z9. OAKLAND•CA,94612 PH.510.763.3601 MEL JOB NO: `}-S PROJECT NAME: ,� DATE: ` ^1"? DSA/OSHPD FILE NO.: REPORT NO:: CARD NO,: _ BUILDING NO.: DSA APPL./OSHPD FACILITY NO:: GAUGE NO.: TECHNICIAN: DSA LEA NO.: 138/289 TEST NO. LOCATION MAX %REL COMPACTION PROBE MOIST. FIELD CURVE EEEVATION DRY REMARKS DEPTH % DENSITY DENSITY NO. FIELD SPECIFIED \0 co CURVE %OPTIMUM SOILTYPE MOISTURE MAX DRY DENSITY,' Method Nudear Gauge 1• The material Was sampled and tested in accordance with the requirements of the 2. The material tested Met the requirements.of the . CC.[]®gA DOSHPD,OWNER,ARCHCLECT;CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:06/07/13 601 BERCUT DRIVE'•'SACRAMENTO CA,95811 PH.916.375.6700 w }+ 4370 CONTRACTORS COMMON •LIVERMORE CA,94551 PH.925.606.7700 Ma 1,l 1SCQpV 43614`hSTREET,SUITE 1429 •OAKLAND ?CA,94612 PH.510.763.3601 Engineering Laboratories, Inc- REPORT NO.: 57866-05-25-2017 DSA/OSHPD FILE NO.: PERMIT NO.: 2016-01557 DSA APPL./OSHPD FACILITY NO.: BLDG.NAME: DSA LEA NO.: 138/289 DSA BLDG.NO.: DSA CARD NO.; DAILY FIELD REPORT PROJECT NAME: PRUNEYARD Double Tree Hotel-side walk and drive*t MEL JOB NO:2570 JOB/SHOP ADDRESS: 1995 S Bascom Ave, Campbell CA 95008 Tuesday DATE: 05/25/2017 NAME OF FABRICATOR,BATCH PLANT,ETC: PAGE NO.: 1 of 2 Arrival Time: 7:30 Overtime Re-inspection❑ Non-Conformance.a TYPE OF INSPECTION- "' EQUIPMENT USED: DOCUMENTS REFERENCED: APPROVED CONSTRUCTION DOCS, Plans,submittals and details. SUMMARY: - - - Arrived at 7:30 am met with Mr.Jim,today i conducted soil compaction test in three deferent locations. f Location#1:Trench insi1he peets coffee building; f' r „cf O ". wit a era and ' a on 3: side coal sin around drive way#5. �l for the test result description please see the attached P - Y table and for the test locations please see the attached _ r drawings Material Sampled/Tested: Qty.of Samples: Location(s)Sampled: Compliance Statement: 1.The work was inspected In accordance with the requirements of the approved project documents;, 2.The work inspected met the requirements of the approved project documents. 3. Material sampling was not performed. SITE AEPRESENTATIVE NAME: Jim INSPECTOR(PRINT): Shah Noor Broomand COMPANY/TITLE: CERTIFICATION NO.: REPORT PROVIDED E-MAIL: SIGNATURE: 0 'NOTE:Signature of the site representative verifies that the MEL Inspector was present on-site and does not indicate acceptance of the work,report or test results. CC:QDSA/QOSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:06/07/13 W MatriSe® ' e DAILY COMPACTION TEST 601BERCUTDRIVE•SACRAMENTO• CA,95811PH.916.375.6700 4370 CONTRACTORS COMMON LIVERMORE• CA,94551 PH.925.606.7700 Engineering Laboratories,Inc. �E P®�$"� 43614`h STREET,SUITE 1429• OAKLAND- CA,94612 PH.510.763.3601 MEL JOB NO: 2570 PROJECT NAME: PRUNEYARD Double Tree Hotel DATE: DSA/OSHPD FILE NO.: REPORT NO.: 57866-05-25-2017 CARD NO.: BUILDING NO.:. DSAAPPL./OSHPD FACILITY NO.; GAUGE NO.: TECHNICIAN: Shah Broomand DSA LEA NO.: 138/289 MAX %RELCOMPACTION TEST NO. LOCATION ELEVATION PROBE MOIST,,, FIELD DRY CURVE REMARKS DEPTH % DENSITY DENSITY NO FIELD SPECIFIED 01 First layer peets building trench -2 6" 16.2 108.2 119.7 7123 90.4 90 Pass 02 Second layer peets building trench -1 6" 15.1 109.1 119.7 7123 91.1 90 Pass 03 Third layer peets building trench -1 6" 14.3 107.8 119.7 7123 90.1 90 Pass Ground level 6' 9.4 127.2 128.3 10748 9.1 95 Pass giv �y� Ground level 6" 11.1 127.0 128.3 10748 99. 95 Pass 06 Sidewalk Ground level 6' 11.5 102.4 128.3 10748 79.8 95 Fail 07 Side walk Ground level 61, 10.6 120.8 128.3 10748 94.2 95 Fail 08 CURVE %OPTIMUM q SOIL TYPE MOISTURE MAX DRY DENSITY Method 7123 Lime Treated Brown Silty Clay With Gravel 13.0 119.7 Nuclear Gauge 10748 . Brown Sandy Clay With Gravel 8.9 128.3 1. The material Was sampled and tested in accordance with the requirements of the approved project documents. 2. The material tested CC:❑DSA/❑OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date: 10/14/14 SIIiMf[IlSM� s le 1,to, •� rS.... ^'Cgc�' r "' -' �t 's f r $ x t a a { S i j # � W : a a a. $Mpr 4 x a i ,.:#a - ,� 3fT7 x T , k � ,�.F.'' EWA- 1p1peAtg a � 0,11a� a t .a >a " y .t r t 14 601 BERCUT DRIVE • SACRAMENTO CA,95811 PH.916.375.6700 gv,l 4370 CONTRACTORS COMMON • LIVERMORE • CA,94551 PH.925.606.7700 MatriSc®pe 43614'hSTREET,SUITE 1429 • OAKLAND qq • CA,94612 PH.510.763.3601 n IN IN Engineering Laboratories, Inc. REPORT NO.: DSA/OSHPD FILE NO:: PERMIT NO.: DSA APPL./OSHPD FACILITY NO.: BLDG.NAME: DSA LEA NO.; 138/289 DSA BLDG.NO.: DSA CARD NO.: DAILY FIELD REPORT PROJECT NAME: Prune yard nut tree MEL JOB NO: 2570 JOB/SHOP ADDRESS: Campbell Thursday DATE: 5-25-17 NAME OF FABRICATOR,BATCH PLANT, ETC: PAGE NO.: 1 of 1 Arrival Time: 6:30 AM Overtime ❑ Re-inspection ❑ Non-Conformance ❑ TYPE OF INSPECTION: EQUIPMENT USED: 3200 rebar inspection 3300 concrete placement and sampling DOCUMENTS REFERENCED: Date on plans Furnished to me for inspection 6-30-18 SUMMARY: I arrived on site to sample concrete and look at rebar placement.Concrete placement was at the C-wall. Rebar at the steps adjacent to the C—wall. I found the rebar to be per the plans detail 11 on sheet S205.The concrete slump and temperature was all so with-in tolerances of the mix and ASTM C-94. Daily;Project Photo Material Sampled/Tested: CONCRETE Qty.of Samples: i set Location(s)Sampled: C Wall. Compliance Statement:All was per plan 1. The work Was inspected in accordance with the requirements of the approved project documents. �2. The work inspected Met the requirements of the approved project documents. 3. Material Sampling Was performed in accordance with the approved project documents. SITE REPRESENTATIVE NAME: INSPECTOR(PRINT): Mike trammel COMPANY/TITLE: CERTIFICATION NO.: 1136145 REPORT PROVIDED E-MAIL: SIGNATURE: "NOTE:Signature of the site representative verifies that the MEL Inspector was present on-site and does not indicate acceptance of the work,report or test results. CC:❑DSA/❑OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:06/07/13 I U;U L+Q 601 BERCUT DRIVE• SACRAMENTO-CA,95811 PH.916.375.6700 6244 PRESTON AVENUE - LIVERMORE- CA,94S51 PH.925,606.7700 . 01111. 1 atriScope u ��"�, ;. 43614 STREET,SUITE 1429 • OAKLAND-CA,94612 PH.510.763.3601 " -��ao-; Engineering Laboratories, Inc. PERMIT NO.: BLDG,NAME: DSA/OSHPD FILE NO.: _ DSA APPL./OSHPD FACILITY NO.: DSA BLDG.NO.: DSA LEA NO.: 138/299 DSA CARD NO.: _ DAILY FIELD REPORT REPORT NO.: PROJECT NAME: ' ' MEL JOB NO: ZQ JOB/SHOP ADDRESS: M T WT F A SU DATE ,`,, / NAME OF FABRICATOR,BATCH PLAN ,ETC: PAGE NO.: of Arrival Time: ' ` A; 15M Overtime ❑ Re-Inspection ❑ Non-Conformance ❑ �s TYPE OF INSPECTION: ❑Earthwork,[]Reber, Oncrete,[] Masonry,❑Shop Fabrication,❑Welding, ❑Material ID,❑ Batch Plant, ❑PT Concrete,❑'Epoxy/Wedge Anchors/Dowels,[] Pull/Torque Testing, []Firepfoofing;[Q'Waterproof ng H.S;1361ting.[]MetaLDecking,_[],Other;. MELTASK.CODE: Q( kQUIPMENTUSED: DOCUMENTS REFERENCED: SUMMARY: _ Material Sampled/Tested ; Qty,of Samples: Location(s)Sampled: Compliance Statement: 1. The work ❑Was/❑ Was Not;inspected;In accordance with the require men ts.ofthe approved❑ DSA/❑ OSHPD protect documents, 2., The work Inspected 13 Met/❑ Did Not Meet the requfrements of the approved❑ DSA/❑ OSHPD prgJectdocuments.y_ I,. Material Sampling approved❑ Was/❑Was Not perfarirled in accordance with the approved❑ DSA/❑ OSHPD ptoJect;,documents. SITE REPRESENTATIVE NAME: INSPECTOR(PRINT): , COMPANY/TITLE: CERTIFICATION NO.: REPORT PROVIDED,E-NIAi6,.. SIGNATUR *NOTE:Signature of the site repre3entativo verfles that the MEL Inspector was present on-site and does not Indicate acceptance of the work,report,or testresults, CC:CIDSA/I]OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:09/01/15 67447 r+a +'� Scapa P"CUT ARIVE S;LIVERM Rr• CA,9 551 PH.925.606.7700 a*' gb+ - c1.�.1'1 62 t4 P.AESYflN hVFNUE t.IVERMOKE;•CA,9RSS1 PH.925.606.770Q +• i+ ' °�!�_ Engineering Laboratories, Inc, 43614°STREET St11TE 1429'"OAKLAND.•CA,94612 PH.510.763.3601 BLDG.NAME: PERMIT NO.: DSA/OSHPD FILE NO.: DSA APPL,/OSHPD FACILITY NO.: _ DSA BLDG.NO.; DSA LEA NO.: 138/289 DSA CARD NO.: DAILY FIELD REPORT REPORT NC.: PROJECT NAME: MEL108NO: JOB/SHOP ADDRESS: M i TH F SA SU DATE: NAME OF FABRICATOR,BATCH PLANT,ETC: PAGE NO.: of Arrival Time: &5PM Overtime ❑ Re-inspection ❑ Non-Conformance ❑ TYPE OF INSPECTION. Ll rKEarthwork,®Rebar,0 Concrete,❑Masonry,❑Shop Fabrication, ❑Welding, ❑Material lD,❑-Ba'tch Plant,0 PT Concrete,[]Epoxy/Wedge Anchors/Dowels,❑Pull/Torque Testing, ❑Fleepecicifing,❑AAz,# reroofing,❑H.S. Bolt ing;❑Metal Decking,0 Other: MEL TASK CODE: lei EQUIPMENT USED: DOCUMENTS REFERENCED: SUMMARY: � _._... ��?� �-jr,. �n�s, �� � *e-�•+a. a,t. a •t.. Material Sampled/Tested, W Location(s)Sampled: Compliance Statement: 1. The work RWas/❑ Was Not Jasiapciciln accordance with the req Ire , nts,of the approved❑ DSA/❑ OSHPD project documents. 2,., The work Inspected❑ Met/ Did Not ee , ie.requirements o e:. pr ved❑ DSA/❑OSHPD proJett documents. 3'. Material Sampling approved Was/❑W Not armed In a. rda ce ith the approved❑ DSA/❑ OSHPD project documents, SITE REPRESENTATIVE NAME:. INSPECTOR(PRINT): COMPANY/TITLE: CERTIFICATION NO.: REPORT PROVIDED E.- -[L SIGNATURE:' 'NOTE:Stgnoture of the sloe representative verifies that the MEL Inspector was present on-site and does not Indicate acceptance of the work,report,or test results. CC:[]DSA/[]OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:09/o1/15 M/�atr1SV'r ®pe DAILY COMPACTION TEST .1.V1ll 6019ERCUTDRIVE •SACRAMENTO•CA,95811 PH.916.375.6700 6244 PRESTON AVENUE•UVERMORE•CA,94551 PH.925.606.7700 •a'r Engineering Laboratories,Inc. REPORT 43614"STREET,SUITE 1429•OAKLAND•CA,94612 PH.510.763.3601 .ag,. 9 9 MEL JOB NO: PROJECT NAME: Q C4�Q, DATE: DSA/OSHPD FILE NO.: REPORT NO.: CARD NO.: BUILDING NO.: DSA APPL./OSHPD FACILITY NO.: GAUGE NO.: TECHNICIAN: DSA LEA NO.: 138/289 PROBE MOIST FIELD MAX CURVE %REL COMPACTION TEST NO. LOCATION ELEVATION DEPTH % bENSrTY DRY NO REMARKS DENSITY FIELD SPECIFIED l CURVE SOILTYPE %OPTIMUM MAX DRY DENSITY Method Is MOISTURE Nuclear Gauge t I. The material Was sampled and tested in accordance with the requirements of the 2. The material tested Met the requirements of the . CC: ❑DSA/❑OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:06/07/13 AIL COMPACTION TEST' 601 BERCUT DRIVE - SACRAMENTO CA,95811 PH.916.375.6700 Mai �� ®�V 6244 PRESTON AVENUE • LIVERMORE • CA,94551 PH.925.606.7700 Engineering Laboratories, InC: R P®RT 436 14�'STREET,SUITE 1429 • OAKLAND -CA,94612 PH.510.763.3601 MELJOB NO: PROJECT NAME: iv DATE: ` DSA/OSHPD FILE NO.: REPORT NO.: CARD NO.:, BUILDING NO.: DSA APPL./OSHPD FACILITY NO.: GAUGE NO.: TECHNICIAN: DSA LEA NO.: 188/289 MAX %REL.COMPACTION TEST NO. LOCATION ELEVATION PROBE MOIST. FIELD p11Y CURVE REMARKS DEPTH % DENSITY DENSITY NO. FIELD SPECIFIED as CURVE SOILTYPE %OPTIMUM MAX DRY DENSITY Method # MOISTURE �. Nuclear Gauge 1. The material Was sampled and tested in accordance with the requirements of the 2. The material tested 'Met the requirements of the CC: ❑DSA/ QOSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER, CONTRACTOR Revision Date: 06/07/1 3 67460 601 EERCUT DRIVE • SACRAMENTO CA,95811 PH.916.375.6700 �� papsMatrScope 9 6244 PRESTON AVENUE • LIVERMORE CA,94551 PH.925.606.7700 9 436 14 STREET,SUITE 1429 • OAKLAND • CA,94612 PH.510.763.3601 Engineering Laboratories, Inc_ PERMIT NO.: »,t� BLDG.NAME: DSA/OSHPD FILE NO.: DSA APPL./OSHPD FACILITY NO.: DSA BLDG.NO.: DSA LEA NO.: 138/289 - --- DSA CARD NO.: DAILY FIELD REPORT REPORT NO.: PROJECT NAME: ¢� MEL JOB NO: 905 10 JOB/SHOP ADDRESS: T W TH F SA SU DATE: NAME OF FABRICATOR,BATCH PLANT,ETC: PAGE NO.: C of Arrival Time: -y., � (PM Overtime ❑ Re-inspection ❑ Non-Conformance ❑� TYPE OF INSPECTION: gEarthwork,❑ Rebar, N Concrete, ❑ Masonry,❑Shop Fabrication, ❑ Welding, ❑ Material ID, ❑ Batch Plant, ❑ PT Concrete, ❑ Epoxy/Wedge Anchors/Dowels, ❑ Pull/Torque Testing, Fireproofing, ❑ Waterproofing, ❑ H.SBolting, 0 Metal Decking, ❑ Other: _ MEL TASK CODE: e EQUIPMENT USED: DOCUMENTS REFERENCED: SUMMARY s ILY - C' 'awes . CA-,to P t, t9> �a G.• 4Sr1`a Material Sampled/Tested. Qty.of Samples: Location(s)Sampled: Compliance Statement: 1. The work %Was/0 Was Not inspected in accordance with the requirements the approved 0 DSA/Q OSHPD project documents. 2. The work inspected I&Met/CJ @ t Meet the r 4erner*.q-� approv d h DSA/El OSHPD project documents, 3. Material Sampling approved W / Wa�.Not .w he approved El DSA/❑ OSHPD project documents. SITE REPRESENTATIVE NA INSPECTOR(PRINT): COMPANY/TITLE: CERTIFICATION NO.: REPORT PROVIDED E-M IL: SIGNATURE: *NOTE:Signature of the site representative verifies that the MEL Inspector was present on-site and does not indicate acceptance of the work,report,or test results. CC!❑DSA/❑OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:09/01/15 0 MatriScope DAILY COMPACTION TEST 601 BERCUT DRIVE - SACRAMENTO - CA,95811 PH.916.375,6700 1 6244 PRESTON AVENUE - LIVERMORE - CA,94551 PH.925.606-7700 Engineering Laboratories, Inc. REPORT 436 14"STREET,SUITE 1429 - OAKLAND - CA,94612 PH.510.763.3601 MEL JOB NO: -975-aq- PROJECT NAME: DATE: 6 DSA/OSHPD FILE NO.: REPORT NO.: CARD NO.: BUILDING NO.: DSA APPL./OSHPD FACILITY NO.: - GAUGE NO.: TECHNICIAN: DSA LEA NO.: 138/289 MAX ---- %REL.COMPACTION TEST NO. LOCATION ELEVATION PROBE MOIST. FIELD DRY CURVE F DEPTH % DENSITY DENSITY NO. FIELD SPECIFIED REMARKS Ck 0 AID CURVE SOIL TYPE %OPTIMUM MAX DRY DENSITY Method # MOISTURE Nuclear Gauge 1. The material Was sampled and tested in accordance with the requirements of the 2. The material tested Met the requirements of the . CC: DIDSA/ E]OSHPD,OWNER,ARCHITECT, CONSTRUCTION MANGER, STRUCTURAL ENGINEER,CONTRACTOR Revision Date: 06/07/13 �00 y� . 601 BERCUT DRIVE SACRAMENTO CA 95811`PH 916,375 6700' *rya ��g 'J �?op „ �� z �;, 6244 PRESTON AVENUE LIVERMORE CA,94SSi-PH 925,606 7700 000 " 43614 STREET,SUITE 1429- OAKLAND CA,946i2 PH,510.763.3601 Englneenpg Laboratories, Inc ,y r PERMIT NO.: BLDG.NAME DSAfOSHPD FILE NO DSA BLDG.Nd •� •9 ' DSA APPL/OSHPD FACILITY NGL:: DSALEA NO.; 138J283 s. DSAtAR0 NO` ROO.: I1 II � i — PROlECi NAtVIE A°'� t �t, t i. AMELJOBNO: JOB/SH11LL4. 4- OP ADDRESS izMT /TH f.SA SU DATE m °P NAME OF FABRICATOR;BATCFI PLA#�T,ETC: ctPAGE NO.' i of k ,� �. Arrival Time• AMJPM � Overtime ❑ Re inspection ❑ �.Ncjn -Co nformarac ❑ ,` TYPEOF INSPECTIQN Q,Earthwork,❑ Rebar,❑Concrete, ❑ Masonry,[],Shop",Fabrication, ❑`Welding;. ❑ Material ID,❑;:Batch Plant,❑ PT Concrete,❑ Epoxy/Wedge Anchors/Dowe.is,;,0 Pgll/Torgiae Testing,: ❑.Fireproofing;'❑Waterproofing, ❑H S Bolting,❑ Metal Decking,❑Other: MELTASIt Cf1DE x a" , '; 'EQUIPMENT USED- DOCUMENTS a 01 . . :SUMMARYY 4 q a aR a f i b 4 q �».g J 3& x'�} y+. � 8 k`'m •''�- ` "t Z f)' iy 3 �4 z 4 bias �� § ��:'3, arrnw�� a•-'a 4 ..� �,,_ .��"'�. �5� t�'s°''"P6��a J � �,i �, 'r a`-«f� ry s gg P g d 1 . I � �' $of..< , .,° °'„� •,x � dd'' _ F oy3 Ad E i e ( a. t ' c 7 "? Material sampled Testedu w CZty,of SamF►les , Location(s)Sampled.;,' i Compliance Statement 1 Tfie work D Was"J'© Was�N r Not rnspected in accordance wrththe requrrements of the approved® DSA j❑ OSHPD project documents.. The work inspected`C7 Met%F bid'Not Meet the requirertieh't'of the approved 0,DSA/11,bsHP6 project documents.': 3 Material Sampiing approved© Was,/0 tntas Not beti`Pormed in accordance with the approved 0 DSA f.E OSFIPD,project documents SITE REPRESENTATIVE NAME _' ., INSPECTOR'{PRINT} ' s COMPANY 'ITLE � . � CERTIFICATIONNO x , X REPORT PRO1lIDED E=MAIL SIC�iVATURE• � NOTE:Srgnaturee.;of the site repieser+tatlVcw"ver, es thaC theAMEt Inspector was present on.sitc Oncl noes`not irl, ate cr ce/itance of the wrrtk,repoit,or zest results t CC:[]DSA f ElOSHpD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,'CONTRACTOR Revision Date:09/01115 ❑ 3102 Industrial Boulevard.West Sacramento,CA 95691, W'NmatriScope Phone(916)375-6700 •Fax(916)375-6702 SOILS TESTING LOGp'� Engineering Laboratories, Inc. ❑ 436 14th Street,-Suite 1029•Oakland,California 94612 9 9 Phone: 510-763-3601 •Fax:510-763-1388 PROJECT NO. PROJECT NAME k ' f g ? OFFICE REPORT NO. LOCATION KEY ELEVATION KEY METHOD KEY BF -Backfill SD Storm Drain BP -Building Pad SW -Sewerline SG -Subgrade FSG -Finish Subgrade' SC -Sandcone ELC -Electrical TR Trench FG -Finish Grade FAB Finish Agg.Base NG -Nuclear Gage EXC -Excavation WL Wall AS -Aggregate Base BTM -Bottom DT -Drive Tube FTG -Footing WTL WTL Waterline DATE TEST NO. LOCATION PROBE DEPTH - ELEV. %M_OIST. DENSITY IRI CURVE NO. %REL.COMPACTION METHOD FIELD SPECIFIED -] wt r� 5, �. .�� r C` �"r' %..; .I„ ,` ";,. 1r ,dam'- • �. -' j , _ s r 1 Distribution of Soils Testing Log Report: White to MS; Canary to Inspector I Technician; Pink to Authorized Project Representative LABORATORY STANDARD;' SOIL TYPE %OPTIMUM MOISTURE MAXIMUM DRY DENSITY,PCF Technician Name: ;i iy Dgte:. . s . hi:IFORMS\LAB\SOILS'TESTING LOG.doc WEIGHMASTER-CERTIFICATE' 82432 THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by'a weighmaster,=whose signature is on this certificate,who is a recognized authority of accuracy,as prescribed by Chapter 7(commencing with section 12700)of Division 5 of the California Business and Professions CWe,administered by Division of Measurement Standards of the California Department of Food and Agriculture. TM 1 ENTERPRISES', INC. CA# 30012 1996 OAKLAND ROAD MC #177583 SAN JOSE, CA 95131-1696 PHONE(408)432-9040 FAx(408) 432-9429 DATE:, f JOB NAME: JOB# SOLD_ TO: P.O.#; ADDRESS: ` DRIVER SHIPPED TO: ` VEHICLE LIC.'NO. SHIPPED VIA TRAILER LIC. SOLD BY CASH CHARGE C.O.D. ON ACCT. CU.YDS. SIZE COMMODITY UNIT AMOUNT Weight in LBS. GROSS WT. TARE WT. NET WT. NET TONS SUB-TOTAL TMT ENTERPRISES,INC.'WEIGHMASTER TAX By� +-: '. � Deputy. TOTAL THE UNDERSIGNED CUSTOMER BY THE PLACING OF THIS ORDER OR THE ACCEPTANCE OF THIS,INVOICE AGREES TO PAY REASONABLE ATTORNEY'S FEES OR COLLECTION CHARGES IN.THE EVENT ACTION HEREAFTER BECOMES NECESSARY FOR THE COLLECTION OF THE VALUE OF THE WORK OR THE MATERIALS'HEREIN AUTHORIZED. NOTICE:A 1-1/2%per month service charge will be charged on all past due balances. RECEIVED BY: PRINT NAME: WEIGHMASTER CERTIFICATE 82273 THIS IS TO OE-ATIFY that the following described commodity was weighed,measured,or counted by a weghmaster,whose signature is on this certificate;who is a recognized authority of accuracy,as prescribed,by Chapter 7(commencing with section 127Q0)of Division 5 of the.California Business and Professions Code,administered by the Division of Measurement Standards of the California Department of Food and Agriculture.. 1 M 1 ENTERPRISES, INC. CA# 30012 1996 OAKLAND ROAD MG#'177583 SAN JOSE, CA 951,31-1696 PHONE(408)432-9040 FAx(408) 432-9429 DATE: ' JOB NAME: JOB# SOLD TO: P.O.# ADDRESS: DRIVER. SHIPPED TO: VEHICLE LIC.NO, SHIPPED VIA TRAILER LIC. - SOLD BY CASH CHARGE C.O.D. ON ACCT. CU.YDS, SIZE COMMODITY UNIT AMOUNT Weight in LBS. GROSS WT. TARE WT. NET WL NET TON S SUB-TOTAL TMT ENTERPRISES,INC.'WEIGHMASTER,_ TAX By- � = (Deputy _. TOTAL THE UNDERSIGNED CUSTOMER BY THE PLACING OF THIS ORDER OR THE ACCEPTANCE OF THIS INVOICE AGREES TO PAY REASONABLE ATTORNEY'S FEES OR COLLECTION CHARGES IN THE EVENT ACTION HEREAFTER BECOMES NECESSARY FOR THE COLLECTION OF THE VALUE OF THE WORK OR THE MATERIALS HEREIN AUTHORIZED. NOTICE:A 1-1/2%per month service charge will be charged on all past due balances. RECEIVED BY: PRINT NAME: TM 1 ENTERPRISES, INC. 15231.4 CA#30012 " 1996 OAKLAND ROAD MC#177583 SAN JOSE,CA 95131-1696 'HONE(408)432-9040 FAX(408)432-9429 ' TRUCK NO. f TRAILER NO. DATE 'UNDERLYING' - - CARRIER — — -------------P:O:tk RECEIVED FROM(CONSIGNOR) DELIVERED TO(CONSIGNEE) ADDRESS-- -- -- ---� ADDRESS - CITY CITY JOB NO. DEBTOR DISTANCE IN MILES JOB NAME' TIME', ! SCALE TAG NO. WEIGHT DATE RECEIVED BY 2 i '4 li 6' COMMODITY TOTAL TONS•/CUBIC YARDS BAGS TRANSPORTED; _ TIME DRIVER REPORTED FOR WORK A.STARTING TIME -y� B.TIME OF START C.OVERALLTIME(FROM TIME OF LAST TRIP' OF LAST TRIP REPORTING FOR WORK TO UNLOADING START OF LAST TRIP PLUS TIME AT END OF DOUBLE RUNNING TIME OF ENDING TIME OF LAST TRIP LAST TRIP PLUS UNLOAD- OF LAST TRIP UNLOADING _ ING'TIME OF LAST LOAD) ELAPSED RUNNING ELAPSED D.DEDUC7IBLE TIME FOR TIME OF+LASTTRIP UNLOADING TIME MEALS OR FAILURE OF OF LAST TRIP I CARRIER EQUIPMENT REMARKS;, `�-NET CHARGEABLE TIME _ CHARGES APPLICABLE HOURLY DEBTOR:AGREES'TO PAY ANY LEGAL FEES,COURT COSTS FOR RATE _ COLLECTION OF DELINQUENT ACCOUNTS,LEGAL RATE OF INTEREST RATE,IN WILL BE,CHARGED FOR ALL PAST DUE ACCOUNTS. CENTS PER TON -x'—. -'__ ---------- -- _. - - ACCESSORIALHELPER_S RECEIVED"IN GOOD ORDER BY AUTHORIZED REPRESENTATIVE OTHER CHARGES PRINT NAME TOTAL X__ MffAlWfMllDNVERlS SIGNATURE � u Form#3010 R.5.14) HERRERNS TWINS TRUCKING 22 � 8 B ASANT KNOLL DRIVE SAN JOSE,GA 95148 PHONE(408),,591-0340 CA#227447 k TRWCK;NO: TRAILER NO. _- DATE ` _. UNDERLYING -- CARRIER 'P.O. RECEIVED FROM(CONSIGNOR)' DELIVEREDTO(CONSIGNEE) ADDRESS ADDRESS CITY — -- CITY JOB NO. DEBTOR DISTANCE IN MILES JOB NAME ' TIME SCALE TAG NO. WEIGHT DATE', RECEIVED BY xa - 2 i-= ,3 4 i5 COMMODITY TOTAL TONS/CUBIC YARDS/'BAGS TRANSPORTED = TIME DRIVER REPORTED FOR WORK A.STARTING TIME B:TIME OF START C.OV.EFIALL TIME t(FROM TIME1 OF LAST TRIP OF,LAST TRIP REPORTING FOR.WORK TO UNLOADING _ START OF LASTTRIP PLUS'' ENDING TIME TIME AT END OF DOUBLE RUNNING TIME OF OF LAST TRIP OF LAST TRIP LASTTRIP PLUS UNLOAD- UNLOADING ING TIME OF LAST LOAD) ,ELAPSED RUNNING', ELAPSED D.DEDUCTIBLE TIME_FOR TIME OF LAST TRIP" UNLOADING TIME MEALS OR FAILURE OF OF LAST TRIP CARRIER EQUIPMENT REMARKS: - NET CHARGEABLE TIME CHARGES APPLICABLE -- HOURLY' DEBTOR AGREES TO PAY ANY LEGAL FEES,COURT COSTS FOR _RATE COLLECTION OF DELINQUENT ACCOUNTS,LEGAL RATE OF INTEREST -- - RATE IN WILL BE CHARGED FOR ALL PAST DUE ACCOUNTS. CENTS PER TON _ x — ACCESSORIAL HELPERS RECEIVED IN GOOD ORDER BY AUTHORIZED REPRESENTATIVE OTHER CHARGES PRINT NAME TOTAL 'DRIVER'SSIGNATURE WEIGHMASTER CERTIFICATE 82274 THIS IS i �TIFY that the following described commodity was weighed,measured,or counted by a weighmaster, whose signature is on this certificate,who is a recognized authuity of accuracy,as prescribed by Chapter?(commencing with section 12700)of Division 5 of the California Business and Professions Cocie,administered by the Division of Measurement Standards of the California Department of Food and Agriculture. TMT ENTERPRISES, INC. CA# 30012 1996 OAKLAND ROAD MC # 177583 SAN JOSE, CA 95131-1696 Ad= PHONE (408) 432-9040 FAx(408)432-9429 DATE: JOB NAME: JOB# SOLD TO: P.O.# ADDRESS: DRIVER SHIPPED TO: VEHICLE"LIC.NO. SHIPPED VIA TRAILER LIC. SOLD BY CASH CHARGE C,O:D. ON ACCT. CU.YDS. SIZE COMMODITY UNIT AMOUNT Weight in LBS. GROSS WT. TARE WT. NET WT. NET TONS' SUB-TOTAL TMT ENTERPRISES,INC.WEIGHMASTER TAX By Deputy i TOTAL THE UNDERSIGNED CUSTOMER BY THE PLACING OF THIS ORDER OR THE ACCEPTANCE OF THIS INVOICE AGREES TO PAY REASONABLEATTORNEY'S FEES OR COLLECTION CHARGES IN THE EVENT ACTION HEREAFTER BECOMES NECESSARY FOR THE COLLECTION OF THE VALUE OF THE WORK OR THE MATERIALS HEREIN AUTHORIZED. NOTICE:A 1-1/2%per month service charge will be charged on all past due balances. RECEIVED BY: PRINT'NAME: 601 BERCUT DRIVE - SACRAMENTO CA,95811 PH.916,375.6700 6244 PRESTON AVENUE • LIVERMORE CA,94551 PH.925.606.7700 MatriScope 436 14"STREET,SUITE 1429 OAKLAND CA,94612 PH.510.763.3601� a, Engineering Laboratories, Inc. PERMIT NO.: BLDG.NAME: DSA/OSHPD FILE NO.: DSA APPL•/OSHPD FACILITY NO.: DSA BLDG.NO.: DSA LEA NO.: 138/289 DSA CARD NO.: DAILY FIELD REPORT REPORT NO.; PROJECT NAME: MEL JOB NO: f' . JOB/SHOP ADDRESS: t M T W TH F SA SU DATE: NAME OF FABRICATOR,BATCH PLANT,ETC: PAGE NO.: ' of -. Arrival Time: 7 - AM/PM ,' Overtime ❑ Re-inspection ❑ Non-Conformance ❑ TYPE OF INSPECTION: [] Earthwork, ❑ Rebar, ❑Concrete,❑ Masonry,❑Shop Fabrication, ❑Welding, ❑ Material ID,❑ Batch Plant,❑ PT Concrete,❑ Epoxy/Wedge Anchors/Dowels,❑ Pull/Torque Testing, ❑ Fireproofing, ❑Waterproofing,❑ H.S. Bolting,❑ Metal Decking,❑Other: MELTASK CODE: q' , EQUIPMENT USED: DOCUMENTS REFERENCED: - 1 SUMMARY: t r Material Sampled j Tested: '' Qty.of Samples:. Location(s)Sampled: Compliance Statement: , 1. The work,'O Was/❑ Was Not inspected in accordance with the requirements of the approved❑ DSA/❑ OSHPD project documents. 2. The work inspected ft] Met/❑ Did Not Meet the requirements of the approved❑ DSA/❑ OSHPD project documents. 3. Material Sampling approved❑ Was/❑Was Not performed in accordance with the approved❑ DSA/❑ O5HPD project documents. SITE REPRESENTATIVE NAME: INSPECTOR(PRINT): COMPANY/TITLE: CERTIFICATION NO.: , REPORT PROVIDED E-MAIL: SIGNATURE: `NOTE:Signature of the site representative verifies that the MEL Inspector was present on-site and does not indicate acceptance of the work,report or test results. CC:❑DSA/[-]OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:09/01/15 " ❑ 3102 Industrial Boulevard+West Sacramento,CA 95691 Phone(916)375-6700•Fax(916)375-6702 MatriScope SOILS TESTING LOG [l 436 aAtPl=Street,Suite 1029.Oakland,California 94612- Engineering Laboratories, Inc. Phone: 510-763-3601 .Fax:510-763-i 388 PROJECT NO. PROJECT NAME OFFICE REPORT NO. _ LOCATION KEY ELEVATION KEY - METHOD KEY BF -Backfilt, SD Storm Drain BP -Building Pad' SW Sewerline SG -Subgrade: FSG Finish Subgrade SC -Sandcone ELC -Electrical TR Trench FG Finish Grade :FAB -Finish Agg.,Base NG Nuclear Gage EXG -Excavation 'WL Wall AB -Aggregate Base BTM -Bottom DT -Drive Tube FTG -Footing WTL WTL Waterline DATE TEST NO. = LOCATION PROBE • ELEV.. % MOIST. DRY C�EPTf URVE NO._ METHOD, METWOR, FiEtD SPECtFtED `", i n_ _ - ' 4 5 u 10 -------------- " _ Y i — , s M1 y _c s n , f r " e s _. Distribution of Soils Testing Log Repo White toMS Carta: =fo(nspectgr l Technician; Pink to Authorized Project Representative LABORATORY STANDARD: "SOIL TYPE, %OPTIMUM MOISTURE MAXIMUM DRY DENSITY,PCF . ^ Technician Name: . , Date: _M:1FORM&LABtSOILS TESTING LOO.doo �� 0'� ty � r;01 PFACUT DttivE - SACRAMENTO CA,95811 pH.916-375.G700 62,14 PRESTON AVENUE LIVERMORE CA,94551 PH_925.606.7700 r�r OP Engineering Laboratories, Inc. 436 14"'STREET,5UrTE 1429 • OAKLAND • CA,94612 PH-510.763.3601 �p�t BLDG. NAME: PERMIT NO.: DSA/OSHPD FILE NO.: DSA BLDG.NO.: — DSA APPL./OSHPD FACILITY NO.: DSA LEA NO.: 138/289 DSA CARD NO..- DAILY FIELD REPORT REPORT NO.: —� PROJECT NAME: MEL JOB NO: V JOB/SHOP ADDRESS: i } M T W TH F SA SU DATE: NAME OF FABRICATOR,BATCH PLANT,ETC: i PAGE NO.: ! of `_. — Arrival Time: " AMPM Overtime ❑ Re-inspection ❑ Non-Conformance ❑ TYPE OF INSPECTION: ❑ Earthwork, ❑ Rebar, []Concrete, ❑ Masonry, ❑Shop Fabrication, ❑ Welding, ❑ Material ID, ❑ Batch Plant, ❑ PT Concrete, ❑ Epoxy/Wedge Anchors/Dowels,❑ Pull/Torque Testing, ❑ Fireproofing, [] Waterproofing, ❑ H.S. Bolting,❑ Metal Decking, ❑ Other: MEL TASK CODE: EQUIPMENT USED: _ f DOCUMENTS REFERENCED: SUMMARY: - i (Material Sampled)Tested: _- - Qty.of Samples: ; Location(s)Sampled: Compliance Statement: 2. The work,,O Was/O Was Not inspected in accordance with the r�gUirements of the approved❑ DSA/❑ OSHPD project documents. 2. The work inspected O Met/❑ Did Not Meet the requirements of the approved❑ DSA/❑ OSHPD project documents. 3. Material Sampling approved l7 Was/❑Was Not performed in accordance with the approved❑ DSA/❑ OSHPD project documents. SITE REPRESENTATIVE NAME: INSPECTOR(PRINT): = ; COMPANY/TITLE: CERTIFICATION NO.: REPORT PROVIDED E-MAIL: SIGNATURE: r' `NOTE:Signature of the site representative verifies that the MEL inspector was present on-site and does not indicate acceptance of the work,report or test results. CC:❑DSA/❑OSHPD,OWNER,ARCHITECT,CONSTRUCTION MANGER,STRUCTURAL ENGINEER,CONTRACTOR Revision Date:09/01/15 7 ® DATE(MM/DD/YYYY) ACC)R® CERTIFICATE OF LIABILITY INSURANCE 2/28/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER,THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,ce liici s may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsem EIVEn CONTACT Sind Lara PRODUCER NAME: Woodruff-Sawyer&Co. MAR _6 2017 PHONE 415-402-6659 Alc No:415-989-9923 50 California Street, Floor 12 E-MAIL slara@wsandco.com San Francisco CA 94111 Public Works AdmifliStratIAi1 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Hartford Fire Insurance Company 19682 INSURED WLBUTLE-01 INSURERB:Sentinel Insurance Company, Ltd. 11000 W.L. Butler Construction, Inc. INSURERC: 204 Franklin Street INSURERD: Redwood City CA 94063 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER:230501504 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN-SR ADDLbUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY Y 57UEAFM3374 3/1/2017 3/1/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence $300.000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JECT PRO- rLOC PRODUCTS-COMPlOP AGG $2,000,000 11 OTHER: Deductible $3,000 A AUTOMOBILE LIABILITY Y 57UEAFM3575 3/1/2017 3/1/2018 Ea accidentSINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OPED SCHEDULED BODILY INJURY(Per accident) $ ALITAUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident Deductible $500-$5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION Y 57WEART1039 3/1/2017 3/1/2018 X P ER STATUTE X 10 EERH Ded:NIA AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT .$1,000,000 OFFICER/MEMBER EXCLUDED? ' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:WLB Project#26522-The Pruneyard, Phase I City of Campbell, its officers, employees and volunteers are included as Additional Insured per the attached forms. Coverage is Primary/Non-Contributory per the attached forms.Waiver of Subrogation applies per the attached form. Policies contain a 30 day notice of cancellation and a 10 day notice of cancellation for non-payment of premium. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Campbell THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 70 N. First Streeet ACCORDANCE WITH THE POLICY PROVISIONS. Campbell CA 95008 AUTHORIZED REPRESENTATIVE I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD I SOLD BY MILPITAS MATI� IALS COMPANY ME suR°��Ar1125`N ILPITAS BLVb MILPITAS; CA 950351 , , PHONE 408'`262 0656 510'656-261.9 „650 9'P 4401 Tflu # pR;yER FAX 408-942=0826 1 WE,MAKE ALL OELIVERIES`INSIDE CURB ANb ON LOT AT'CUSTOMERS RISK ON L '' TIME LOADED ; AND ACCEPT NQ RESPONSIBILITY FOR DAMAGES RES,ULTING.FROM SUCH DELIERY IT.IS CUSTOMERS R,ESPONSIBILITYTO HANDLE:THESE MATERIALS SAFELYAND ARRIVE JOB , PROPERLY. :. WAAN NG: "Materials`areJrrltating to the,skln and.eyyes because they contain:Portland,Cement,so wear-rubber boots"and sraRrPouR , gloves,' Prolonged.coritact.lxla'ycajf$e:burrls AVoid,contactwitheyes"and iolonged�contactuithskin.'In'case.ofcontact with"skin:or eyy"es flush thorou'ghly,With water If irritatibn•perslsts,get'medical,attention. "Precaution must be.observed'. because.elk- !'burns occlar.wlth little warning and"fftLLtle•heat is sensed: END Pauli WEIGHMA3TERCERTIFICATE THIS IS TO;CERTIFY that the fallowing descrlbed cofnmodity*as wejgh"ed,measured,or counted by,a'wei hmasfer„whose signature is on this certificate,who is :r s,,'teeognized authority of accuracyy,,as preEicribedi z,Chapter7(commencing With'Secti66,127,00)oi4)ivislon'5'of the California Business and Professions.Code, a'ministered by the-Divlsiomof Measurement Stan ards of,the Californla,Department of'Food,and Agrlcultur'e.:_ ' ARRIVE PLANT fi/IILPI7AS MATERIALS CO 4�VATER AD®ED<jA� J B GA Lon(s -DEPk�11-Y WEIGHII/I4STER CUSTOMER ID RHONE NUMBER JOB/P.O.NUMBER DATE ,f TICKET _lhf SOLD TO '': DELIVER TO 1 r f) :I t f i II � LOAD# SLUMP ! Is F1 .Z Ill. gUANTJTY OUANTI, PRC3DUCF PRODUCT E CTENDEO „ UNIT OF UNI `THISLOAD RELIVEFIED CgOE a DESCRIPTION MEASURE PRIOE PRICE 7 r � rt 1�11�►� ( IZIt� �, 'I�I� ;b.il v's�i �.atl,lil`£�F19..,1,� 1 r�£•? - _ £:.4 � - - y. TOTAL MINUTES ALLOWED MINUTES -STAND',B�( D SUB TOTAL qA, = @ t ...I�_.It#�MINUTE uyer a s to pay t e amount owe wen ue u er a tees o a month) service c-ar es a ua to 11 2%. er- $ALEs TAX Y 9 p Y Y g. q p month (18%per annum)°of the oGtstandin' balance of principal;, up as liqquidated damages. A',SERVICE CHARGE of ffi20 Will be chargetl on,any returned check Necessary ATTORNEY'FEES,.COLLECTION AND SUIT COSTS'wll be sTaN BY charged on any unpaid bells Mil etas Materials w it not beheld 11abte or res onatble for the removal or re lacement of an material once It is dote ted and laced at the o6site ry ` fl R T 4 OTHER l�-7 Vr-uv1+' 11ILP � SOLD BY: MILPITAS MATERIALS COMPANY (p WEIGHED/ IVIATE�� � MEASURED AT:1 125 N. MILPITAS BLVD. MILPITAS, CA 95035 PHONE: 408-262-0656 510-656-2619 650-969-4401 TRUCK# DRIVER �® FAX: 408-942-0826 WE MAKE ALL DELIVERIES INSIDE CURB AND ON LOT AT CUSTOMERS RISK ONLY TIME LOADED AND ACCEPT NO RESPONSIBILITY FOR DAMAGES RESULTING FROM SUCH DELIVERY. IT IS CUSTOMERS RESPONSIBILITY TO'HANDLE THESE MATERIALS SAFELY AND ARRIVE JOB•" PROPERLY. WARNING: Materials are irritating to the skin and eyes because they contain Portland Cement,so wear rubber boots and START POUR gloves. Prolonged contact may cause burns. Avoid contact with eyes and prolonged contact with skin. In case of contact with skin or eyes flush thoroughly with water. If irritation persists,get medical attention. Precaution must be observed because alkali burns occur with little warning and little heat is sensed. END POUR`<' WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weighmaster,whose signature is on this certificate,who is a j recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code, ARRIVE PLANT administered by the Division of Measurement Standards of the California Department of Food and Agriculture. WATER ADDED AT JOB: MILPITAS MATERIALS CO. GALLONS DEPUTY WEIGHMASTER CUSTOMER ID PHONE NUMBER JOB/P.O.NUMBER DATE TICKET .... .. , SOLD TO DELIVER TO '- LOAD# SLUMP I� QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE .._ . .. -.i .:.f 1. _. STAND BY TOTAL MINUTES ALLOWED MINUTES CHARGED MINUTES SUB TOTAL CHARGE @ :.1QMINUTE If bu er fails to a the amount owed when due,buyer agrees to a month) Service charges equal to 11/2%per SALES TAX Y PY Y 9, PY Y . 9 q month (18%per annum)of the outstanding balance of principal due as liquidated damages. A SERVICE CHARGE of$20 will be charged on any returned check. Necessary ATTORNEY FEES,COLLECTION AND SUIT COSTS will be STAND BY charged on any unpaid bills. Milpitas Materials will not be held liable or responsible for the removal or replacement of an material once it is accepted and laced at the'obsite. OTHER RECEIVED BY TOTAL -)A SOLD BY: MILPITAS MATERIALS COMPANY ME MEASURED N. MILPITAS BLVD. MILPITAS, CA 95035 PHONE: 408-262-0656 510-656-2619 650-969-4401 'TRUCK'# DRIVER FAX: 408-942-0826 ;i' WE MAKE ALL DELIVERIES INSIDE CURB AND ON LOT AT CUSTOMERS RISK ONLY TIME LOADED AND ACCEPT NO RESPONSIBILITY FOR DAMAGES RESULTING FROM SUCH DELIVERY. IT IS CUSTOMERS RESPONSIBILITY TO HANDLE THESE MATERIALS SAFELY AND ARRIVE JOB PROPERLY. ' WARNING: Materials are irritating to the skin and eyes because they contain Portland Cement,so wear rubber boots and START POUR gloves. Prolonged contact may cause bums. Avoid contact with eyes and prolonged contact with skin. In case of contact with skin or eyes flush thoroughly with water. If irritation persists,get medical attention. Precaution must be observed because alkali bums occur with little warning and little heat is sensed. END POUR . WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weighmaster,whose signature is on this certificate,who is a recognized authority of accuracy,as prescribed by Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code, ARRIVE PLANT administered by the Division of Measurement Standards of the California Department of Food and Agriculture. WATER ADDED AT JOB: GALLONS MILPITAS MATERIALS CO. DEPUTY WEIGHMASTER CUSTOMER ID PHONE NUMBER JOB/P.O.NUMBER , DATE TICKET !`if ;fit:, _ SOLD TO DELIVER TO r Y ...4'a t.,i.3 I i..,C, i'f d.5.:A. .1.;!e� ,. ... : .. .. �.... i•._.i._I, , LOAD# SLUMP QUANTITY'" QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED - THIS LOAD ' DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE STAND BY TOTAL MINUTES ALLOWED MINUTES CHARGED MINUTES SUB TOTAL CHARGE @ ,,<11IMINUTE If buyer fails to pay the amount owed when due,buyer agrees to pay monthly service charges equal to 11 2 per SAL Es TAX month (18%per annum)of the outstanding balance of principal due as liquidated damages. A SERVICE CHARGE of$20 will be charged on any returned check. Necessary ATTORNEY FEES,COLLECTION AND SUIT COSTS will be STANDBY charged on any unpaid bills. Milpitas Materials vAll not be held liable or responsible for the removal or replacement of an material once it is accepted and laced at the"obsite. OTHER . „- TOTAL 10=111ft=111111=111 riv SOLD BY: MILPITAS MATERIALS COMPANY MEASURED A-0125 N. MILPITAS BLVD. MILPITAS, CA 95035;. .': PHONE: 408-262-0656 510-656-2619 650-969-4401 TRUCK# DRIVER FAX: 408-942-0826 WE MAKE ALL DELIVERIES INSIDE CURB AND ON LOT AT CUSTOMERS RISK ONLY TIME LOADED AND ACCEPT NO RESPONSIBILITY FOR DAMAGES RESULTING FROM SUCH DELIVERY. .° . IT IS CUSTOMERS RESPONSIBILITY TO HANDLE THESE MATERIALS SAFELY AND ARRIVE JOB PROPERLY. WARNING: Materials are irritating to the skin and eyes because they contain Portland Cement,so wear rubber boots and START POUR gloves. Prolonged contact may cause-burns. Avoid contact with eyes and prolonged contact with skin. In case of contact with skin or eyes flush thoroughly with water. If irritation persists,get medical attention. Precaution must be observed because alkali burns occur-with little warning and little heat is sensed. END POUR WEIGHMASTER CERTIFICATE THIS IS TO CERTIFY that the following described commodity was weighed,measured,or counted by a weighmaster,whose signature is on this certificate,who is a recognized authority of accuracy,as prescribed,by',Chapter 7(commencing with Section 12700)of Division 5 of the California Business and Professions Code, ARRIVE PLANT administered by the Division of Measurement Standards of the California Department of Food and Agriculture. MILPITAS MATERIALS CO. WATER ADDED AT JOB" GALLONS DEPUTY WEIGH MASTER CUSTOMER ID PHONE NUMBER JOB/RO.NUMBER fir. DATE TICKET SOLD TO DELIVER TO LOAD# SLUMP _€:"r:( I"j�l,_:; :�-n QUANTITY QUANTITY PRODUCT PRODUCT UNIT OF UNIT EXTENDED THIS LOAD DELIVERED CODE DESCRIPTION MEASURE PRICE PRICE i i.. t;r f.i f. h.i!,''i '1• is:..r;'r° 1 Y"i'?f l til�r'Y¢ti.:l f i".. i• o;'? '�1 STAND BY TOTAL MINUTES ALLOWED MINUTES CHARGED MINUTES SUB TOTAL CHARGE - @ ?HZ MINUTE I buyer ails to a the amount owed,when due,buyer agrees to a month) service charges a ual to 11 2%per SALES TAX Y PY Y 9 PY Y 9 q month (18%per annum)of-the outstanding balance of principal due as liquidated damages. A SERVICE CHARGE of$20 will be charged on any returned check. Necessary ATTORNEY FEES,COLLECTION AND SUIT COSTS will be STAND BY charged on any unpaid bills. Milpitas Materials will not be held liableor res onsibld for the removal or replacement of anV material once it is accepted and placed at the'obsite. OTHER 1113C/%C111cm QV. A YAK TOTAL I W MEMORANDUM CITY OF CAMPBELL City Clerk's Office To: Doris Quai Hoi, Assistant Engineer Date: March 21, 2017 From: Andrea Sanders, Deputy City Clerk Subject: Parcel Map and Street Dedication for properties located on S. Bascom Avenue At its regular meeting of March 21, 2017 City Council adopted Resolution 12128 approving the Parcel Map and accept the street dedication as shown on the map, and abandon the existing street easements superseded by said street dedications along S. Bascom Avenue and E. Campbell Avenue for the property located at 1875, 1887, 1901, 1919, 1995 & 1999 S. Bascom Avenue. A certified copy of Resolution 12128 has been attached for your records. i IVeo. MAR Z 4 Zq Public Works gdminfst �,On` ` iq JI RESOLUTION NO. 12128 APPROVAL OF A PARCEL MAP INCLUDING ACCEPTANCE OF STREET DEDICATION IN FEE AS SHOWN ON SAID MAP, AND ABANDONMENT OF STREET EASEMENTS SUPERSEDED BY SAID STREET DEDICATIONS ALONG S. BASCOM AVENUE AND E. CAMPBELL AVENUE FOR THE PROPERTIES LOCATED AT 1875, 1887, 1901, 1919, 1995 & 1999 S. BASCOM AVENUE WHEREAS, on September 6, 2016, the City Council adopted Resolution No. 10392 approving a Tentative Subdivision Map for the property located at 1875, 1887, 1901, 1919, 1995 & 1999 S. Bascom Avenue; and WHEREAS, said Tentative Map included approval of the abandonment of existing street easements along S. Bascom Avenue and E. Campbell Avenue, as recorded on October 25, 1996 in Document No.13496778, said abandonment to be implemented on the Parcel Map; and WHEREAS, public street dedication is necessary to accommodate the approved use of the property and has been offered for dedication in Fee on the Parcel Map; and WHEREAS, the Parcel Map has been prepared, reviewed by staff, and found to be in compliance with the Tentative Map, the Subdivision Map Act and Title 20 of the Campbell Municipal Code. NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of Campbell that the Parcel Map is hereby approved and the Public Streets offered for dedication as shown on said map, are hereby accepted in conformity with the terms for which it is offered and that the existing street easements along S. Bascom Avenue and E. Campbell Avenue are hereby abandoned. PASSED AND ADOPTED this 21st day of March, 2017 by the following roll call vote: AYES: Councilmembers: Waterman, Cristina, Landry, Resnikoff, Gibbons NOES: Councilmembers: None ABSENT: Councilmembers: None APPR VED: "Liz" Gibbons, Mayor ATTEST: it)" --1, THE FOREGOING INSTRUMENT IS A TRUE Wend W d CityClerk AND CORRECT COPY OF THE ORIGINAL y ON FILE IN THIS OFFICE. ATTEST:WENDY WOOD,CITY CLERK BY =E,;q- CA DATED f 1 ® DATE(MM/DD/YYYY) A�® CERTIFui ATE OF LIABILITY INSURAI 2/28/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,ce Iles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorse I n IV PRODUCER NAME:CONTACT Sind Lara Woodruff-Sawyer&Co. MAR —6 2017 PHONE .415-402-6659 r1c.No):415-989-9923 50 California Street, Floor 12 E-MAIL San Francisco CA 94111 .slara@wsandco.com Public Works Administrntlon INSURERS AFFORDING COVERAGE NAIC# INSURER A:Hartford Fire Insurance Company 19682 INSURED WLBUTLE-01 INSURERB:Sentinel Insurance Company, Ltd. 11000 W.L. Butler Construction, Inc. INSURERC: 204 Franklin Street Redwood City CA 94063 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:230501504 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 57UEAFM3374 3/1/2017 3/1/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X� OCCUR PREMISES Ea occurrence $300,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY� JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: Deductible $3,000 A AUTOMOBILE LIABILITY Y 57UEAFM3575 3/1/2017 3/1/2018 Ea aBcidentSINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS X AUTOS Per accident Deductible $50D-$5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DE D RETENTION$ $ B WORKERS COMPENSATION Y 57WEART1039 3/1/2017 3/1/2018 X PER X ETH- Ded:N/A AND EMPLOYERS'LIABILITY STATUTE ER Y ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:WLB Project#26522-The Pruneyard, Phase I City of Campbell, its officers,employees and volunteers are included as Additional Insured per the attached forms. Coverage is Primary/Non-Contributory per the attached forms.Waiver of Subrogation applies per the attached form. Policies contain a 30 day notice of cancellation and a 10 day notice of cancellation for non-payment of premium. tv MR _--�_ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Campbell THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 70 N.First Streeet ACCORDANCE WITH THE POLICY PROVISIONS. Campbell CA 95008 AUTLIORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Policy Number: 57UEAFM8575 )MMERCIAL AUTOMOBILE HA99160312 THIS ENDORSEMENT CHANGES THE POLICY.. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form,the provisions of this endorsement apply. 1. BROAD FORM INSURED d. Any "employee" of yours while using.a A. Subsidiaries and Newly Acquired or covered "auto" you don't own, hire or Formed Organizations borrow in your business or your The Named Insured shown in the personal affairs. Declarations is amended to include: C. Lessors as Insureds (1) Any legal business entity other than a Paragraph A.I. -WHO IS AN INSURED -of partnership or joint venture, formed as a Section II - Liability Coverage is amended to subsidiary in which you have an add: ownership interest of more than 50% on e: The lessor of a covered "auto"while the the effective date of the Coverage Form. "auto" is leased to you under a written However, the Named Insured does not agreement if: include any subsidiary that is an (1) The agreement requires you to "insured" under any other automobile policy or would be an "insured" under provide direct primary insurance for such a policy but for its termination or the lessor and the exhaustion of its Limit of Insurance. (2) The"auto"is leased without a driver. (2) Any organization that is acquired or. Such a leased "auto" will be considered a farmed by you and over which you covered "auto" you own and not a covered maintain majority ownership. However, "auto"you hire. the Named Insured does not include any D. Additional Insured if Required by Contract newly formed or acquired organization: (1) Paragraph A.1. -WHO IS AN INSURED (a) That is a partnership or joint - of Section it - liability Coverage is venture, amended to add: (b) That is an "insured" under any other f. When you have agreed, in a written policy, contract or written agreement, that a (c) That has exhausted its Limit of person or organization be added as Insurance under any other policy, or an additional insured on your (d) 180 days or more after its business auto policy, such person or acquisition or formation by you, organization is an"insured", but only unless you have given us notice of to the extent such person or the acquisition or formation. organization is liable for "bodily Coverage does not apply to "bodily b l the conduct of an a nearury" or"property ed"under injury" or"property damage" that results Y from an "accident" that occurred before paragraphs a. or b. of Who Is An you formed or acquired the organization. Insured with regard to the B. Employees as Insureds ownership, maintenance or use of a Paragraph A.1. - WHO IS AN INSURED -of covered"auto." SECTION 11 - LIABILITY COVERAGE is amended to add: m 2011,The Hartford(Includes copyrighted material Form HA 9916 0312 of ISO Properties. Inc..with its oennission.) Paae 1 of 5 'Policy Number:57UEAFM357,' The insurance afforded to any such E. Primary and Non-Contributory if additional insured applies only if the Required by Contract "bodily injury" or "property damage" Only with respect to insurance provided to occurs: an additional insured in 1.D. - Additional (1) During the policy period, and Insured If Required by Contract, the (2) Subsequent to the execution of such following provisions apply: written contract, and (3) Primary Insurance When Required By (3) Prior to the expiration of the period Contract of time that the written contract This insurance is primary if you have requires such insurance be provided agreed in a written contract or written . to the additional insured. agreement that this insurance be (2) How Limits Apply primary. If other insurance is also If you have agreed in a written contract primary, we will share with all that other Y 9 insurance by the method described in or written agreement that another Other Insurance 5.d. person or organization be added as an additional insured on your policy, the' (�) Primary And Non-Contributory To Other most we will pay on behalf of .such Insurance When Required By Contract additional insured is the lesser of: If you have agreed in a written contract (a) The limits of insurance specified in or written agreement that this insurance the written contract or written is primary and non-contributory with the agreement; or additional insured's own insurance, this insurance is primary and we will not (b) The Limits of Insurance shown in seek contribution from that other the Declarations. insurance. Such amount shall be a part of and not Paragraphs(3) and (4)do not apply to other in addition to Limits of Insurance shown insurance to which the additional insured in the Declarations and described in this has been added as an additional insured. Section. When this insurance is excess, we will have no (3) Additional Insureds Other Insurance duty to defend the insured against any "suit" if If we cover a claim or "suit" under this any other insurer has a duty to defend the Coverage Part that may also be covered insured against that "suit". If no other insurer by other insurance available to an defends, we will undertake to do so, but we will additional insured, such additional be entitled to the insured's rights against all insured must submit such claim or"suit' those other insurers. to the other insurer for defense and When this insurance is excess over other indemnity. insurance, we will pay only our share of the However, this provision does not apply amount of the loss, if any, that exceeds the sum to the extent that you have agreed in a of written contract or written agreement (1) The total amount that all such other that this insurance is primary and non- insurance would pay for the loss in the contributory with the additional insured's absence of this insurance; and own insurance. (2) The total of all deductible and self-insured {4) Duties in The Event Of Accident, Claim, amounts under all that other insurance. Suit or Loss If you have agreed in a written contract We will share the remaining loss, if any, by the or written agreement that another method described in Other Insurance 5.d. person or organization be added as an 2. AUTOS RENTED BY EMPLOYEES additional insured on your policy, the Any "auto" hired or rented by your "employee" additional insured shall be required to on your behalf and at your direction will be comply with the provisions in LOSS considered an"auto"you hire. CONDITIONS 2. - DUTIES IN THE The OTHER INSURANCE Condition is amended EVENT OF ACCIDENT, CLAIM , SUIT by adding the following: OR LOSS — OF SECTION IV — BUSINESS AUTO CONDITIONS, in the same manner as the Named Insured, 02011, The Hartford(Includes copyrighted material Form HA 9916 0312 of ISO Properties, Inc., with its permission.) Page 2 of 5 POLICY NUMBER: 57UEAFM3374 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - OPTION This endorsement modifies insurance provided under the-following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Designated Project(s)Or Location(s) Or O anization s : Of Covered Operations: City of Campbell, its officers,employees and volunteers All California Operations Attn:Department of Public Works 70 North First Street Campbell,CA 95008 Information required to complete this Schedule if not shown above will be shown in the Declarations. A. With respect to those person(s) or organization(s) (3) In connection with "your work" for the shown in the"Schedule above when you have additional insured at the project(s) or agreed in a written contract or written agreement location(s) designated in the Schedule to provide insurance such as is afforded under this and included within the "products- policy to them, Subparagraph f., Any Other completed operations hazard", but only if: Party, under the Additional Insureds When (a) The written contract or written Required By Written Contract, Written agreement requires you to provide Agreement Or Permit Paragraph of Section II — such coverage to such additional Who Is An Insured is replaced with the following: insured at the project(s) or location(s) f. Any Other Party designated in the Schedule; and Any other person or organization who is not (b) This Coverage Part provides an insured under Paragraphs a. through e. coverage for "bodily injury" or above, but only with respect to liability for "property damage" included within the "bodily injury", "property damage"or"personal "products-completed operations and advertising injury" caused, in whole or in hazard". part, by your acts or omissions or the acts or The insurance afforded to the additional omissions of those acting on your behalf: insured shown in the Schedule applies: (1) In the performance of your ongoing (1) Only if the "bodily injury" or "property operations for such additional insured at damage" occurs, or the "personal and the project(s) or location(s) designated in advertising injury" offense is committed: the Schedule; (a) During the policy period; and (2) In connection with your premises owned by or rented to you and shown in the (b) Subsequent to the execution of such written contract or written agreement; Schedule;or and Form HS 24 80 0713 Page 1 of 2 ® 2013,The Hartford (Includes copyrighted material of Insurance Services Office, Inc„with its permission.) (c) Prior to the expiration of the period of When You Add Others As An Additional time that the written contract or written Insured To This Insurance agreement requires such insurance (a) Primary Insurance When Required By be provided to the.additional insured. Contract (2) Only to the extent permitted by law; and This insurance is primary if you have agreed (3) Will not be broader than that which you in a written contract or written agreement that are required by the written contract or this insurance be primary. If other insurance written agreement to provide for such is also primary, we will share with all that additional insured. other insurance by the method described in With respect to the insurance afforded to the Paragraph (c)below. This insurance does not person(s)or organization(s) that are additional apply to other insurance to which the insureds under this endorsement, the additional insured in the Schedule has been following additional exclusion applies: added as an additional insured. This insurance does not apply to "bodily (b) Primary And Mon-Contributory To Other injury", property damage or personal and Insurance When Required By Contract advertising injury" arising out of the rendering This insurance is primary to and will not seek of, or the failure to render, any professional contribution from any other insurance architectural, engineering or surveying available to an additional insured under your services, including: policy provided that: (1) The preparing, approving, or failing to (i) The additional insured in the Schedule is prepare or approve maps, shop drawings, a Named Insured under such other opinions, reports, surveys, field orders, insurance; and change orders, designs or specifications; (ii) You have agreed in a written contract or or written agreement that this insurance (2) Supervisory, inspection, architectural or would be primary and would not seek engineering activities. contribution from any other insurance The limits of insurance that apply to the additional available to the additional insured in the insured shown in the Schedule are described in the Schedule. Limits Of Insurance section. (c) Method Of Sharing How this insurance applies when other insurance is If all of the other insurance permits available to the additional insured is described. in the contribution by equal shares, we will follow Other Insurance Condition in Section IV — this method also. Under this approach, each Commercial General Liability Conditions,except as insurer contributes equal amounts until it has otherwise amended below. paid its applicable limit of insurance or none of B. With respect to insurance provided to the the loss remains,whichever comes first person(s) or organization(s) that are additional If any of the other insurance does not permit insureds under this endorsement, the When You contribution by equal shares, we will Add Others As An Additional Insured To This contribute by limits. Under this method, each Insurance subparagraph, under the Other insurer's share is based on the ratio of its Insurance Condition of Section IV—Commercial applicable limit of insurance to the total General Liability Conditions is replaced with the applicable limits of insurance of all insurers. following: All other terms and conditions in the policy remain unchanged. Page 2 of 2 FOrin HS 24 80 0713 Policy Number: 57UEAFM3374 that are in excess of the applicable limit of insurance. (7) When You Add Others As An Additional An agreed settlement means a settlement and release Insured To This Insurance of liability signed by us, the insured and the claimant or Any other insurance available to an additional the claimant's legal representative. insured. 4. Other Insurance However, the following provisions apply to other If other valid and collectible insurance is available-to. insurance available to any person or the insured for a loss we cover under Coverages A or organization who is an additional insured under B of this Coverage Part, our obligations are limited as this coverage part follows: (a) Primary Insurance When Required By a. Primary Insurance Contract This Insurance is primary except when b. below This insurance is primary if you have agreed applies. If other insurance is also primary, we will in a written contract or written agreement share with all that other insurance by the method that this insurance be primary. If other described in c. below. insurance is also primary, we will share with b. Excess Insurance all that other insurance by the method described in c.below. This insurance is excess over any of the other insurance, whether primary, excess, contingent or {b} Primary And Non-Contributory To Other on any other basis: Insurance When Required By Contract (1) Your Work If you have agreed in a written contract, written agreement, or permit that this That is Fire, Extended Coverage, Builder's Risk, insurance is primary and non-contributory Installation Risk or similar coverage for "your with the additional insured's own insurance, work''; this insurance is primary and we will not (2) Premises Rented To You seek contribution from that other insurance. That is fire, lightning or explosion insurance for Paragraphs (a) and (b) do not apply to other premises rented to you or temporarily occupied insurance to which the additional insured has by you with permission of the owner; been added as an additional insured. (3) Tenant Liability When this insurance is excess, we will have no That is insurance purchased by you to cover duty under Coverages A or B to defend the insured your liability as a tenant for "property damage" against any "suit" if any other insurer has a duty to to premises rented to you or temporarily defend the insured against that "suit". if no other occupied by you with permission of the owner, insurer defends, we will undertake to do so, but we (4) Aircraft,Auto Or Watercraft will be entitled to the insured's rights against all those other insurers. If the loss arises out of the maintenance or use When this insurance is excess over other of aircraft, "autos" or watercraft to the extent not insurance, we will pay only our share of the amount subject to Exclusion g. of Section I — Coverage of the loss, if any, that exceeds the sum of: A—Bodily Injury And Property Damage Liability; (5} Property Damage to Borrowed Equipment®r (1) The total amount that all such other insurance Use Property Elevators would pay for the loss in the absence of this insurance; and If the loss arises out of "property damage' to (2) The total of all deductible and self-insured borrowed equipment or the use of elevators to amounts under all that other insurance. the extent not subject to Exclusion j. of Section I - Coverage A - Bodily Injury And Property We will share the remaining loss, if any, with any Damage Liability; other insurance that is not described in this Excess Insurance provision and was not bought specifically (6) When You Are Added As An Additional to apply in excess of the Limits of Insurance shown Insured To Other Insurance in the Declarations of this Coverage Part Any other insurance available to you covering C. Method Of Sharing liability for damages arising out of the premises or operations, or products and completed If all of the other insurance permits contribution by operations, for which you have been added as equal shares,we will follow this method also. Under an additional insured by that insurance; or this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. Page 14 of 18 HG 00 0106 05 It LLY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA r 0 Policy Number: 57WEART1039 Endorsement Number: ,., Effective Date: 3/01/2017 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: W L BUTLER CONSTRUCTION INC C 204 FRANKLIN ST aREDWOOD CITY, CA 94063 n We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not o enforce our right against the person or organization named in the Schedule. (This agreement applies only to the 10 extent that you perform work under.a written contract that requires you to obtain this agreement from us.) M You must maintain payroll records accurately segregating the remuneration of your employees while engaged in 9-0 the work described in the Schedule. The additional premium -for this endorsement shall be 2 % of the Califomia workers' compensation premium otherwise due on such remuneration. saw ® SCHEDULE E� Person or Organization Job Description ANY PERSON OR ORGANIZATION ALL FROM WHOM YOU ARE REQUIRED BY WRITTEN*CONTRACT OR AGREEMENT TO OBTAIN THIS WAIF OF RIGHTS FROM US. F� C i� O i� Countersigned by Authorized Representative Form WC 04 03 06 (1) 'Printed in U.S.A. Process Date:3/01/2017 Policy Expiration Date: 3/01/201 s INSURANCE REQUIREMENTS CHECKLIST �C v-,r\e��Ckq Permit#!�—'AC 013-c So CIPProject# Consultant/Contractor: The following insurance is required. of all consultants/contractors working in the 'City of Campbell public right-of-way. Insurance certificates must be accepted by City staff before work can begin. These insurance requirements apply to work being performed under an Encroachment Permit and work being performed under contract for Capital Improvement Projects. Limits Commercial General Liability for bodily, personal injury and property damage: ci/ $1,000,000 per.occurrence, and ❑ $1,000,000 general aggregate limit applying separately to the project, or ❑/ $2,000,000 general aggregate limit. d Policy expiration date Automotive Liability: ;V- "Any Auto" checked on certificate �1 $1,000,000 per accident'for bodil injury and property damage qz�- Policy expiration date Workers' Compensation and Employer's Liability ❑ Waiver of Subrogation clause $1,000,000 per accident for bodil/ injury or disease oaf. Policy expiration date Course of Construction (if required in Special Provisions) ❑ Completed value of the project ❑ Policy expiration date Required Endorsements.to General Liability and Automobile Liability Policies Additional Insured Endorsement: The City, its officers, employees and volunteers are named as additional insured. (Reference Project Location/Permit Number) The insurance coverage afforded to the Additional Insured is primary insurance. Cancellation area: ❑ Cancellation area of certificate edited to delete "endeavor to" and "but failure to mail such notice shall impose no obligation or liability of any kind upon the company, its agents or representatives". OR should say: Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. ❑ Workers' Compensation Insurance Sheet Submitted . For General Contractor ❑ For Developer or Owner J:\FORMS\Templates\Insurance Requirements\Insurance Requirements Cklist.doc (Rev 08 14) Page 1 t Acceptability of Insurer(s) ❑ Insurer(s) has current A.M. Best Rating of A:VII and is authorized to transact business in the State of California. Name: ys, o.�f��o( � �`�`NAIC# NO% Rating: Authorized in CA: Name: NAIC# Rating: Authorized in CA: Name: NAIC# Rating: Authorized in CA: Name: NAIC# Rating: Authorized in CA: ❑ Campbell Business License # Expirati n:. �k Contractors License# v Class: Expiration: ``6 Insurance Certificate Reviewed ` Initi Is Date Copy of Insurance Certificate placed in tickler file one month prior to expiration. J:\FORMS\Templates\Insurance Requirements\Insurance Requirements Ulist.doc (Rev o8 14) Page 2 I l ® DATE(MMIDDIYYYY) ACC)R® CERTIFICATE OF LIABILITY INSURANCE 2/3/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT Sindy Lara Woodruff-Sawyer&Co. PHONE 415-402-6659 FA(AIX 415-989-9923 50 California Street, Floor 12 EMAIL San Francisco CA 94111 - slara@wsandco.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Hartford Fire Insurance Company 19682 INSURED WLBUTLE-01 INSURER B: W.L. Butler Construction, Inc. INSURERC: 204 Franklin Street Redwood City CA 94063 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:2137098367 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE'AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A B POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y 57UEAQT2281 3/1/2016 3/1/2017 _ EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE �X OCCUR PREMISES Ea occurrence $300,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY JECT LOC - PRODUCTS-COMP/OPAGG $2,000,000 OTHER: Deductible $3,000 A INEDUAUTOMOBILE LIABILITY Y 57UEAQT2282 3/1/2016 3/1/2017 O accciden N LE LIMIT $1,000,000 X ANY AUTO - BODILY INJURY(Per person) $ AUTOWNED BODILY INJURY(Per accident) $ X HIRED AUTOS NSCHEDULED NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident Deductible $500-$5,000 UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION Y 57VVEAQT9984 3/1/2016 3/1/2017 X PER X OTH- Ded:N/A YIN AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI$1.000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:WLB Project#26522-The Pruneyard, Phase I City of Campbell, its officers, employees and volunteers are included as Additional Insured per the attached forms. Coverage is Primary/Non-Contributory per the attached forms.Waiver of Subrogation applies per the attached form. Policies contain a 30 day notice of cancellation and a 10 day notice of cancellation for non-payment of premium. (4:7 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Campbell THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 70 N.First Streeet ACCORDANCE WITH THE POLICY PROVISIONS. Campbell CA 95008 AUTHORIZED REPRESENTATIVE 2� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Policy Number: 57UEAQT2282 COMMERCIAL AUTOMOBILE HA 9916 0312 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROAD FORM ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM To the extent that the provisions of this endorsement provide broader benefits to the "insured" than other provisions of the Coverage Form, the provisions of this endorsement apply. 1. BROAD FORM INSURED d. Any "employee" of yours while using a A. Subsidiaries and Newly Acquired or covered "auto" you don't own, hire or Formed Organizations borrow in your business or your The Named Insured shown in the personal affairs. Declarations is amended to include: C. Lessors as.Insureds (1) Any legal business entity other than a Paragraph A.1. -WHO IS AN INSURED -of partnership or joint venture, formed as a Section 11 - Liability Coverage is amended to subsidiary in which you have an add: ownership.interest of more than 50% on e. The lessor of a covered "auto"while the the effective date of the Coverage Form. "auto" is leased to you under a written However, the Named Insured does not agreement if. include any subsidiary that is an "insured" under any other automobile (1} The agreement requires you to policy or would be an "insured" under provide direct primary insurance for the lessor and such a policy but for its termination or the exhaustion of its Limit of Insurance. (2) The "auto" is leased without a driver. (2) Any organization that is acquired or Such a leased "auto" will be considered a formed by you and over which you covered "auto" you own and not a covered maintain majority ownership, However, "auto"you hire. the Named Insured does not include any D. Additional Insured if Required by Contract newly formed or acquired organization: (1) Paragraph A.I. - WHO IS AN INSURED (a) That is a partnership or joint - of Section 11 - Liability Coverage is venture, amended to add: (b) That is an "insured" under any other f. When you have agreed, in a written policy, contract or written agreement, that a (c) That has exhausted its Limit of person or organization be added as Insurance under any other policy, or an additional insured on your (d) 180 days or more after its business auto policy, such person or acquisition or formation by you, organization is an "insured", but only unless you have given us notice of to the extent such person or the acquisition or formation. organization is liable for "bodily Coverage does not apply to "bodily injury" or"property damage" caused injury"or"property damage" that results by the conduct of an"insured"under from an "accident" that occurred before paragraphs a. or b. of Who Is An you formed or acquired the organization. Insured with regard to the B. Employees as Insureds ownership, maintenance or use of a Paragraph A.1_ -WHO IS AN INSURED -of covered"auto." SECTION 11 - LIABILITY COVERAGE is amended to add: ©2011, The Hartford(includes copyrighted material Form HA 99 16 0312 of ISO Properties, Inc.,with its permission.) Page 1 of 5 Policy Number:57UEAQT2282 The insurance afforded to any such E. Primary and Non-Contributory if additional insured applies only if the Required by Contract "bodily injury" or "property damage" Only with respect to insurance provided to occurs: an additional insured in 1.1). - Additional (1) During the policy period, and Insured If Required by Contract, the (2) Subsequent to the execution of such following provisions apply: written contract, and (3) Primary Insurance When Required By (3) Prior to the expiration of the period Contract of time that the written contract This insurance is primary if you have requires such insurance be provided agreed in a written contract or written to the additional insured. agreement that this insurance be (2) How Limits Apply primary. If other insurance is also primary, we will share with all that other If you have agreed in a written contract insurance by the method described in or written agreement that another Other Insurance 5.d. person or organization be added as an additional insured on your policy, the (�} Primary And Non-Contributory To Other most we will pay on behalf of such Insurance When Required By Contract additional insured is the lesser of: If you have agreed in a written contract (a) The limits of insurance specified in or written agreement that this insurance the written contract or -written is primary and non-contributory with the agreement;or additional insured's own insurance, this insurance is primary and we will not (b) The Limits of Insurance shown in seek contribution from that other the Declarations. insurance. Such amount shall be a part of and not Paragraphs(3) and (4) do not apply to other in addition to Limits of Insurance shown insurance to which the additional insured in the Declarations and described in this has been added as an additional insured. Section. When this insurance is excess, we will have no (3) Additional Insureds Other Insurance duty to defend the insured against any "suit" if If we cover a claim or "suit" under this any other insurer has a duty to defend the Coverage Part that may also be covered insured against that "suit". If no other insurer by other insurance available to an defends, we will undertake to do so, but we will additional insured, such additional be entitled to the insured's rights against all insured must submit such claim or "suit" those other insurers. to the other insurer for defense and When this insurance is excess over other indemnity. insurance, we will pay only our share of the However, this provision does not apply amount of the loss, if any, that exceeds the sum to the extent that you have agreed in a of: written contract or written agreement (�) The total amount that all such other that this insurance is primary and non- insurance would pay for the loss in the contributory with the additional insured's absence of this insurance; and own insurance. {4) Duties in The Event Of Accident, Claim, (2) The total of all deductible and self-insured amounts under all that other insurance. Suit or Loss If you have agreed in a written contract We will share the remaining loss, if any, by the method described in Other Insurance 5.d. or written agreement that another person or organization be added as an 2. AUTOS RENTED BY EMPLOYEES additional insured on your policy, the Any "auto" hired or rented by your "employee" additional insured shall be required to on your behalf and at your direction will be comply with the provisions in LOSS considered an "auto"you hire. CONDITIONS 2. - DUTIES IN THE The OTHER INSURANCE Condition is amended EVENT OF ACCIDENT, CLAIM , SUIT by adding the following: OR LOSS — OF SECTION iV — BUSiNESS AUTO CONDITIONS, in the same manner as the Named Insured. ©2011, The Hartford(Includes copyrighted material Form HA 9g t6 0312 of ISO Properties, Inc.,with its permission.) Page 2 of 5 POLICY NUMBER: s7 uFA QT2281 UY THIS. ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES PR CONTRACTORS - OPTION I This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Designated Project(s)Or Location(s) Or O anization s : Of Covered Operations: City of Campbell, its officers,employees and volunteers All California Operations Attn:Department of Public Works 70 North First Street Campbell,CA 95008 Information required to complete this Schedule, if not shown above will be shown in the Declarations. A. With respect to those person(s) or organization(s) (3) In connection with "your work" for the shown in the Schedule above when you have additional insured at the project(s) or agreed in a written contract or written agreement location(s) designated in the Schedule to provide insurance such as is afforded under this and included within the "products- poiicy to them, Subparagraph f., Any Other completed operations hazard",but only if: Party, under the Additional Insureds When (a) The written contract or written Required By Written Contract, Written agreement requires you to provide Agreement Or Permit Paragraph of Section II — such coverage to such additional Who Is An Insured is replaced with the fallowing: - insured at the project(s) or location(s) f. Any Other Party designated in the Schedule; and Any other person or organization who is not (b) This Coverage Part provides an insured under Paragraphs a. through e. coverage for "bodily injury" or above, but only with respect to liability for "property damage" included within the "bodily injury", "property damage" or"personal "products-completed operations and advertising injury" caused, in whole or in hazard". part, by your acts or omissions or the acts or The insurance afforded to the additional omissions of those acting on your behalf: insured shown in the Schedule applies: (1) In the performance of your ongoing (1) Only if the "bodily injury" or "property - operations for such additional insured at damage" occurs, or the "personal and the project(s) or location(s) designated in advertising injury"offense is committed: the Schedule; (a) During the policy period;and (2) In connection with your premises owned by or rented .to you and shown in the (b) Subsequent to the execution of such written contract or written agreement; Schedule; or and Form HS 24 80 dT 13 Page 'I of 2 © 2013,The Hartford (includes copyrighted material of Insurance Services Office, Inc:, with its permission.) (c) Prior to the expiration of the period of When You Add Others As An Additional time that the written contract or written Insured To This Insurance agreement requires such insurance (a) Primary Insurance When Required By be provided to the additional insured. Contract (2) Only to the extent permitted by law; and This insurance is primary if you have agreed (3) Will not be broader than that which you in a written contract or written agreement that are required by the written contract or this insurance be primary. if other insurance written agreement to provide for such is also primary, we will share with all that additional insured. other insurance by the method described in With respect to the insurance afforded to the Paragraph (c) below. This insurance does not person(s)or organization(s)that are additional apply to other insurance to which the insureds under this endorsement, the additional insured in the Schedule has been following additional exclusion applies: added as an additional insured. This insurance does not apply to "bodily (b) Primary And Non-Contributory To Other injury", "property damage" or "personal and Insurance When Required By Contract advertising injury" arising out of the rendering This insurance is primary to and will not seek of, or the failure to render, any professional contribution from any other insurance architectural, engineering or surveying available to an additional insured under your services, including: policy provided that: ('I) The preparing, approving, or failing to (i) The additional insured in the Schedule is prepare or approve maps, shop drawings, a Named Insured under such other opinions, reports, -surveys, field'orders, insurance, and change orders, designs or specifications; (ii) You have agreed in a written contract or or written agreement that this insurance (2) .Supervisory, inspection, architectural or would be primary and would not seek . engineering activities. contribution from any other insurance The limits of insurance that apply to the additional available to the additional insured in the insured shown in the Schedule are described in the Schedule- Limits Of Insurance section. (c) �Iethod Of Sharing How this insurance applies when other insurance is If all of the other insurance permits available to the additional insured is described in the contribution by equal shares, we will follow Other Insurance Condition in Section IV — this method also. Under this approach, each Commercial General Liability Conditions,except as insurer contributes equal amounts until it has otherwise amended below. paid its applicable limit of insurance or none of B. With respect to insurance provided to the the loss remains,whichever comes first person(s) or organization(s) that are additional If any of the other insurance does not permit insureds under this endorsement, the When You contribution by equal shares, we will Add Others As An Additional Insured To This contribute by limits. Under this method, each Insurance subparagraph, under the - Other insurer's share is based on the ratio of its Insurance Condition of Section IV—Commercial applicable limit of insurance to the total General Liability Conditions is replaced with the applicable limits of insurance of all insurers. following: All other terms and conditions in the policy remain unchanged. Page 2 of 2 Form HS 24 80 07 13 Policy Number:57UEAQT2281 that are in excess of the applicable limit of insurance. (7) When You Add Others As An Additional An agreed settlement means a settlement and release Insured To This Insurance of liability signed by us, the insured and the claimant or Any other insurance available to an additional the claimants legal representative. insured. 4. Other Insurance However, the following provisions apply to other If other valid and collectible insurance is available to insurance available to any person or the insured for a loss we cover under Coverages A or organization who is an additional insured under j B of this Coverage Part, our obligations are limited as this coverage part follows: (a) Primary Insurance When Required By a. Primary Insurance Contract This insurance is primary except when b. below This insurance is primary if you have agreed applies. If other insurance is also primary, we will in a written contract or written agreement share with all that other insurance by the method that this insurance be primary. If other described in c. below. insurance is also primary, we will share with b. Excess Insurance all that other insurance by the method described in c. below. This insurance is excess over any of the other insurance, whether primary, excess, contingent or (b) Primary And Non-Contributory To Other n any other basis: Insurance When Required By Contract (1) Your Work If you have agreed in a written contract, written agreement, or permit that this That is Fire, Extended Coverage, Builder's Risk, insurance is primary and non-contributory Installation Risk or similar coverage for "your with the additional insured's own insurance, work"; this insurance is primary and we will not (2) Premises Rented To You seek contribution from that other insurance. That is fire, lightning or explosion insurance for Paragraphs (a) and (b) do not apply to other premises rented to you or temporarily occupied insurance to which the additional insured has by you with permission of the owner; been.added as an additional insured. (3) Tenant Liability When this insurance is excess, we will have no That is insurance purchased by you to cover duty under Coverages A or B to defend the insured your liability as a tenant for."property damage" against any "suit" if any other insurer has a duty to to premises rented to you or temporarily defend the insured against that "suit". if no other occupied by you with permission of the owner; insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all (4) Aircraft,Auto Or Watercraft those other insurers. If the loss arises out of the maintenance or use When this insurance is excess over other of aircraft, "autos" or watercraft to the extent not insurance, we will pay only our share of the amount subject to Exclusion g. of Section I — Coverage of the loss, if any, that exceeds the sum of. A—Bodily Injury And Property Damage Liability; (1) The total amount that all such other insurance (5) Property Damage to Borrowed Equipment Or would pay for the loss in the absence of this Use Of Elevators insurance; and If the loss arises out of "property damage" to (2) The total of all deductible and self-insured borrowed equipment or the use of elevators to amounts under all that other insurance. the extent not subject to Exclusion j. of Section I - Coverage A - Bodily Injury And Property We will share the remaining loss, if any, with any Damage Liability; other insurance that is not described in this Excess Insurance provision and was not bought specifically (6) When You Are Added As An Additional to apply in excess of the Limits of Insurance shown Insured To Other Insurance in the Declarations of this Coverage Part. Any other insurance available to you covering c. Method Of Sharing liability for damages arising out of the premises or operations, or products .and completed If all of the other insurance permits contribution by operations, for which you have been added as equal shares, we will follow this method also. Under an additional insured by that insurance; or this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. Page 14 of 18 HG 00 0106 05 y . , THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA r• 0 Policy Number. 57 WEA QT9984 Endorsement Number: Effective Date: 03/01/16 Effective hour is the same as stated on the Information Page of the policy. Named Insured and Address: W L BUTLER CONSTRUCTION INC o - rn 204 FRANKLIN ST H REDWOOD CITY, CA 94063 a Ln We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not (N enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) M You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. c The additional premium -for this endorsement shall be 2 % of the California workers' compensation premium otherwise due on such remuneration. SCHEDULE Person or Organization Job Description i� ANY PERSON OR ORGANIZATION ALL FROM WHOM YOU ARE REQUIRED BY WRITTEN CONTRACT OR AGREEMENT TO OBTAIN THIS WAITER OF RIGHTS FROM US. i Countersigned by Authorized Representative Form WC 04 03 06 (1) Printed in U.S.A. Process Date: 03/10/16 Policy Expiration Date: 03/01/17 i LOCATIONS & ENTITIES V9.0 PAGE NUMBER: 1 DATE: 02/15/2017 City of Campbell MODULE : busgenrpt TIME: 07:51:32 GENERAL BUSINESS REPORT - ALL LICENSES SELECTION CRITERIA: ' BUS. ID BUSINESS ID BUSINESS ADDRESS ESTAB DT LICENSE NO CATEGORY ISSUE DT EXPIRAT. STAT ---------- ------------------------------ ------------------------------ -_______ ________ ____ 020507 ROBERT BUTLER CONSTRUCTION 13088 MONTROSE ST 05/10/04 68655 1799A 05/10/04 C PARC ID: STATUS: C DATE CLOSED: 08/03/05 OWNER : BUTLER, ROBERT SARATOGA CA 95070 021783 W L BUTLER CONSTRUCTION 204 FRANKLIN ST 10/07/05 76410 1799A 10/07/05�12/31/17 P� PARC ID: STATUS: 0 OWNER : BILL BUTLER REDWOOD CITY CA 94062 TOTAL BUSINESSES: 2 • . CERTIFIED o RECEIPT n Domestic Mail Only o u For delivery information,� .� .USE 7 Certified Mail Fee O $ Extra Services&Fees(check box,add tee as appropriate) ❑Retum Receipt(hardcopy) $ ❑Return Receipt(electronic) $ Postmark 7 ❑Certified Mall Restricted Delivery $ Here :1 ❑Adult Signature Required $ :1, ❑Adult Signature Restricted Delivery$ Postage O $ n rota,Post,Mr. Dean Rubinson n $ Sent To CFEP Pruneyard, LLC 111 Sutter Street #800 sYaaia , ` ----------.San Francisco CA 94612 City,State, r A receipt(this portion of the Certified Mail label). for an electronic retum receipt,see a retail A unique Identifier for your mailpiece. associate for assistance.To receive a duplicate Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPSO-postmarked Certified Mail receipt to the A record of delivery(including the recipients retail associate. signature)that Is retained by the Postal Service'" Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,oC to the addressee's authorized agent uportantReminders., Adult signature service,which requires the You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mall®,First-Class Package Service®, available at retail). or Priority Mail®service. -Adult signature restricted delivery service,which Certified Mail service is notavallable for requires the signee to be at least 21 years of age International mail. and provides delivery to the addressee specified Insurance coverage is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not avallable at retail). of Certified Mail service does not change the To ensure that your Certified Mail receipt is Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark If you would like a postmark on For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy retum receipt, complete PS Form 3811,DemesficRetum Receipt,attach PS Form 3811 to your mailpiece; IMPORTANT.Save trds receipt for your records. r:,,,..,'ARnfl_c.,61 gnu ia—.<.,r acu 7Mn.ro-nnn-ana7 • . - - CERTIFIED o n Domestic u r p USIE �. Certified Mail Fee n $ Extra ServiCes&Fees(chock box,add fee as eppropdate) ❑Return Receipt(hardcopy) $ ❑Return Receipt(electronic) $ Postmark ❑Certified Mail Restricted Delivery $ Here ❑Adult Signature Required $ :3 ❑Adult Signature Restricted Delivery$ Postage $ r Total Postage an $ Ellis Partners n Sent To C/O CFEP Pruneyard a :I StreetiHAP(., 111 Sutter St.,#800 cry,Ytwtw-2!P+a San Francisco, CA 94104 v.. ...�U 1^'- �^7 '1 GC f.11VV1uVA UM Ivu VMVully ucucuw. r A receipt(this f the Certif ed Mail labep. for an electronic return receipt,see a retail 1 A unique ident four Wilpiece. associate for assistance.To receive a duplicate Electronic verification of delivery or attempted r return-mceipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the r A record of delivery(Including the recipient's retail associate. signature)that Is retained by the Postal Service- Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent mportant Reminders. Adult signature service,which requires the r You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Maila,First-Class Package Service°, available at retail). or Priority Mail®service. Adult signature restricted delivery service,whict r Certified Mail service is notavailabie for requires the signee to be at least 21 years of ag, International mail. and provides delivery to the addressee specified r Insurance coverage is not available for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark If you would like a postmark on r For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail Item at a Post Office-for the following services: postmarking.If you don't need a postmark on this Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. ■ Complete items 1,2,.and 3. A. Signature ■ Print your name and address on the reverse X ❑Agent so that we can return the card to you. G ❑Address e E Attach this card to the back of the mailpiece, B. Re eived by(Printed Name) C.`Datp of iv ry or on the front if space permits. �/ 1. Article Addressed to:_ D. Is delivery address different from item 1? ❑Yes - If YES,enter delivery address below: ❑ No Ellis Partners 111 Sutter St., Suite 800 !San Frani1:isco, CA 94104 'Attn: Dean Rubinson - '3. Service Type ❑Priority Mail Express® I I II1II I'll III I III 111111111111111111 I II IIIIII I I I I I I I I I O Adult Signature ❑Registered MailW Adult Signature Restricted Delivery ❑Registered Mail Restricts Certified Mail® Delivery 9590 9402 4354 8190 5485 97 ertified Mail Restricted Delivery ❑Return Receipt for El Collect on Delivery Merchandise ?._Article_Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery Signa rmatlonT^ O Insured Mail ignature Confirmation 7003 3110 0001 3650 1221 113(over 55Ma Restricts ry Restricted Delivery 'S Form 3811.July:2015 PSN 7530-02-000-9053 1 Domestic Return Receipt USPS TRACKING# First-Class Mail JillPostage&Fees Paid USPS Permit No.G-10 9590 9LI02 4354 8190 5485 97 United States •Sender:Please print your name,address,and ZIP+4®in this box• Postal Service UIPSELL 70 a lortii F;rsi Street 1 Campbell, CA 95004. & - �C ;�a1 -Cczz-fie P!'ii'���'i''� �''i11'tiiiii:;li' '1�i)r11trt`'i11jij 1,iilftji�,7 ZENDER- COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A.74a�4 ■ Print your name and address on the reverse X ❑Agent so that we can,return the card to you. Addresse ■ Attach this card to the back of the mailpiece, B. Received by 09ted Na ) C Date gf DelivejZ or on the front if space permits. '),- I. Article Addressed to: D. Is delivery address different from item 17 ❑Yes If YES,enter delivery address below: 0 No Mr. Dean Rubinson CFEP Pruneyard, LLC 111 Sutter Street,#800 San"Francisco, CA 94612 '3. Service Type ❑Priority Mail Express® I I I II I'll I'I I III IIII I II I'llll'I ll II III III 0 Adult Signature ry ❑Registered MailT" dull Signature Restricted Delivery ❑Registered Mail Restrict Certified Mail® Delivery 9590 9402 4354 8190 5488 56 ❑Certified Mail Restricted Delivery O Return Receipt for ❑Collect on Delivery Merchandise 7_Article.Numheclfransfer--from-serviceJabell ❑Collect on Delivery Restricted Delivery 11 Signature Confirmation* O Insured Mail ❑Signature Confirmation 7 017; 3 3 8 0 H 0 0 ; 0 8,0 7 -7i5 Q Insured Mail ResMcted Delivery Restricted Delivery I I J I I(o'ver$5l)O) IIIt Iitl!I f P:S Form,3811,JUIv;2015 P"SN 7530-02-000-9053, Domestic Return Receipl USPS TRACKING# First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 4354 8190 5488 56 United States •Sender: Please print your name,address,and ZIP+4®in this box• Postal Service Public Works City of Campbell 70 N. First Street Campbell. CA 95008 f't!' ! I i�t'S!�'l) I•�i � ii� 1}iil �'li' •,ll } ii �f i } I�I � LPND^NE AREq \N \ SEE LANOSG4PE BANS Q JSOE FOOT I � EXISTING AC TRAIL _ ' BIOTRTREAN.ENT �, EMSTINGCURB—. 'I.ATRIUM GRATE T 1T%iA DISCHMGE INVERT I6]94 I, 33 `, •, e-9 C3.1 G3.1 Oc. �S—UG_---05 Ei'S CIF—GR SCHEDULE iB PVC _:b•_.' F_XISTLNG FIRE ___ so�s=a.lxn — SEE DETA&B ON SHEET SWI FOR PIPE HYDRANT TO . _ PENETRATION DETAIL __— REMAIN `�\ rW—W—W—W EXISTING CURB - R I• 3 WITH NDS TRASH CAPTURE BUCKET _ EXISTING POWER TO BE CONNECTED TG IBS]2 TONEW TRASHCOMPACTOR NV 10J.090Ui SEE ARCHITECTURE PLANSFOR , —_ ---------_-- j5 3 TRASH ENCLOSUREDETA&S S 6 NDSDURASLOPETRENCH DRNN _ I 2Vt to 0 g iiL AL 0.5w INTERNAL SLOPE EXISTING pµ� ENCLOSURE ROOF DRAINS TO iRi CH _ I METING CURB 1 TOWER 1 C DRNN.SEEARCHITECIURALPLANS I r — I \ W � L JJ I ❑ I 1v w VIw I �I� � � S5—S5 SS LSS�k -SS SS-55— I: 3�go HN s " PLANTING AND IRRIGATIOI g8 DUE _ � P1µ PROVIDEPLANTINGATORY6V ASFOLLOWS:5GALLONJul gC.g a�ON CENTER SET PLANTS WITH ROOT MOMS E. �MOW �F 7 q IRRIGATION ¢4g 1. REMOVE EXISTING SPRINKLERS AND LATERAL LINES FROM FC TRASH ENCLOSURE, S 0o 2. INSTALL NEW SPRINKLERS TO PROVIDE HEEAD TO HEAD COW MODIFIED LANDSCAPE AREAS. C 3. CONNECTNEW bPRINKLERSTOEXISTINGANDADJACENTLAT IRRIGATED SHRW AREA. =7 � UTILITY NOTES: F,Iy I. SANITARY SEWER OW!LATERALS HDLE LOWLI EUNLESSOTHE TO�TARY EW SHALL 6E 0.5'AOOVE NANNOLE FLOW LINE UNLESS OTHERWI 2. 6UILDING SEWER SHALL BE PVC SOR26 UNLESS OTHERWSE: SANRARY SEWER LATERALS SHALL HAVE A MINNUM SLOPE OTHERWISE SPECIFIED. J. PROVIOE IO'MINIMUM SEPARATION BETWEEN BUILDING SANE ' AND WATER,WHEN POSSIBLE.MNNUM VERTICALCLEARAHC IF IN THE FIELD.THE VERTICAL SEPARATION BEIWEEN SANIT, STORM DRAIN CROSSING IS LESS THAN 1P'.A HIGH DENSITY 1 SHALL BE USED BETWEEN PIPES. 4. ALL PRNATE ON SITE STORIA DRAIN PIPE BAWLER THAT IT 1 SHALL BE PVC SOR35,IF DEPTH IS GREATERTHAN Y.WITH A I OF 1%UNLESS OTHERWSE SPECIFIED. 5. ALL PRNATE ON-SITE STORM BRAIN PIPE 12'OR LARGER INI BE PVC SOR35,IF DEPTH IS GREATER THAN 3'.STORM BRAIN MINIMUM SLOPE OF 0.5%UNLESS OTHERWISE SPECIFIED. 6. JOINT TRENCH DESIGN SHOWN FOR INFORMATION ONLY.GEE T. CO NTRACTORTOEXPOSEEXISTINGGRAVRYCONNECTIONP CHECK NVERTS PRIOR TO THE CONSTRUCTION OF NEW UTIL ENGINEER OF ANY DISCREPANCIES. & ALLWATERSHOULDMAINTNNTWRTICALCLEARANCEFR. UTIIJTIESAND SHALL HAVE A DEPTH OF T MINIMUM. S. NSTALL FULL TRASH CAPTURE DEVICE AT ALL SD INLETS. : 6' �3 ) ;5 31.4 6 �` � �\ Asmj „ ,.�.�..r-rr,_.�.•�.' ,}1 f3� �-w•�r.,�:�, ) l- PERFORATED REVISED, . . - r .. .. .. METAL PANEL ( .. Its v STANDING SEAM d C ., N S.S.D. ) 1 METAL DECK S.S.D. T-�..: �._.__ - OL i; C° i 1 S88 , S 3 3$� k$ bR ,RF O g- ., .. .. . CMU•PAINTED "� LUM SD i 1 1 1 1 I 1 r CORRUGATED METAL GATE i CORRUGATED--�— o . '1 11 I 1 1 b' kg • METAL GATE- PAINTED ' I'.1 i .. .,(_.'TOR:IE YDRANT : �.h l^ s o v'f g, x § s "��$ ? _ 3 E I y MIN � :2'SOUARE TUBING.------- 11 I 1 1 �` _. .. ( iE v ? §•sill s pi4.jta INN," r lil 1 t ? _ 1 I11 1 1 • 1 ;T I :. - .. ... ^. {I - + )3•8 riP -i TYP ENCLOSURE NORTHELEVATION�� ..-.-.-._- ._..__.._... . . .., . : . TRASH ENCLOSURE r . 30 4� 1a 1o1n^�- . }ta 1:0^ 1i4 �o• 103rY ^,� �-' --- ""v . ^rl-'�••"l^ ,,.U_.v_,� .ice_• r'`.r"Y-r"l `"� I7 91/1`T,O.ROOF-(.', '^^ .. STANDING SEAMd . oerx9. 6-00.IMF METAL DECK S.S.D. . . . �,✓.. i . r A-DOWNSPOUT,CONNECT) - ---� METAL GUTTER. - V �1 METALGUTTERTO P � TO TRENCHDRAIN -t �.�-'. l.- - - - - MATCH METAL-. 1,;.�%_.-.0 n„r'.�:e.% �oyooryoa n3$3 c 2�ogoyoc$'�o47S i{io ROOF DECK.:. I..,^^,� .rv-•.. _ __CMU-PLANTED I �0 0044Y cry u..$1 0 �Soh,c+o5 VS 7�v5 . . t '.J. - . . .. PERFORATED- ' L # c`f4ko$S5 v3gg vg . "(. DOWNSPOUT,' I. I ' METAL PANE4 `� $ RjL`� + CONNECTTO--• .i, PERFORATED: . . d S 4,E 3 zg RRKk R l� TRENCH DRAIN 41 I" .I METAL PANEL (E)FIRE HYDRANT. ,1 ... . . F,I ;�,$ $EIeaE x e TO REMAIN i 1(. : i)I? P " 5 TRASH ENCLOSURE W EST ELEVATIO ��_�..� �.__ _�� _ _�-�_ _ .____.-_ J 2� RASH E C _ _____ I &� - p.p LOSURE;O ^, ��..•'. •. aaaa���� ,- 1 J UTH ELEVATION ,,✓... � `Sr `.. ,+��J � ..�r��rrZ,.' .r-y..l`t^y l Y. �..,rl,...~' J � l �I II l) i _ r' SHEET NOTES r i (E)BIKE PATH l ,•L I `\ _ ____ - \\\( - 1.TYPE IIA CONSTRUCTION;NOT �I i iJ \ EXCEPTION 2D,PER CFC 304,13,. 21 / (E)BOLLARDSTO REMAIN ... 2.1 HQURROOFPER'tALPfl19.USE - i (N)BIOTFIEATMEW�) FENDOLITE M-11 SPiiAY-ON CELL,SEE CIVILt - S _�1 ( FIREP OOFING PER UCH1S348, /•r [ C DRAWINGS-0ELTA2? t .,� ,2ti�\ - E j taam� O FIRE HYDRANT TO REMAI'� MINIMU t I �_ : FOLLOWS:ROOF DECK52S It6' j r ✓ ._ I. _ 29'.-0 ) _ t - - THICK SUPPORTING BEAMS SB - / � �! THICK l ti.. —' �.` i•1' -a� ._m A J� . .- ,2-.-1'�L-FFEPFTDOFIN l3 STRUCTURAL F--SYSTtM PERU S27USE CA CO NDOLIT -ON ,�IFE R13348,PER UL _ 1 (E)POWER FOR TRASH �T-=-' 25 qY COMPACTOA �I c x�u; MINIMUM 9A8'THICK. O PACTORS,SED 4.SEE A800 FOR MATERIAL "� C. REFERENCES:. . . Fv - 5.PAINT SPRAY-ON fIREPRIbFING t %j r SLOPE TO EAN C y3 - -1 � { APPfi0VEDjIN SOD. r ELOCATE.(E)' � . . • \ of �3� ./ .�., ... _ _ -_ _ -a, - .. . . �(}t t�'l"'/---/-r -r �/,�f/'S�\_�,�\ REMOVE(E)P1'EWTRENHDRAIN C REMOVE(E)FISCD .PAVING ASRE GMu-PAINTED ---- ' m I •,� �f '% T 1875 S BAS.COM AVE '� 4 20' 3314 a � ✓j�/ / r /s� SITE REL ATEAE .`.''. ., >— I BLDZ 6 0131-1 _ /`� . r� (E)CURB a COMPACTOR 2r-21l2. OR . t z I SITE GRADING F - } PRUNEYARD PHASE I . �4 Ii DELTA.3-38 REVISIONS t; i 711912017 0 o .. ;NEW TRASH COMPACTOR ENCLOSURE EBI$TIN OTHA _- -""_-_ TRASH ENCLOSURE TREATMENT SUMMARY TABLE STORMWATER CALCULATIONS j USING FLOW a VOLUME BASED TREATMENT MEASURES TSFATM2NTCONTAOL SUMAAAR'7 DRAINAGEAREANUMSER 87 Nest ioml PovmnmV bb"lA—.t a 1 TOW Draw eMab BA1P-Ar(R) 56.304 y/Aalrmge .p—ipePA— Blobeotmmt HardArto Nae OffmArraT—ted tn0t kl{uryious SlafafA Ms R') 56,304 $ �' AYm ImPerv/Pus ArM Ala Lt.) d Arm Nat TYwmd1. Net?—finenl PAaYe +!) I A/) irmted MotmofmmfCetls 2 Wean m Proco sc%) 1O0 s PAase2 e J Mean AnuW Pmc tlon N 14.9 Undei natcd 23.E07 2318V - 2'. 23,607 -23.907 4 Woh cbsnl toD—Ro-Son Jose Al mtMAPga (in) 13.9 ! 5 Ratnaalpocarreclion factor 1 1.07 Notrtatmem 8 Solt br drshe jjd DMA 91 54X10 0 Cell 1.275 0 �' 7 Awn Eama • D(em) B 9 Naraatment Wsb Iw No droAupO ereo TOTAI 54304 0 Cell 2,275 1,900 23,9172 32,e47 6 WtOeeN sore fmm s(x' toms h p,56 e 'vo sxvwovvun>•atwakAASMen0.semnry 0.60 Del ; 5 G 8 Sha Uro B/.a'-WeLr OuaGry D..Ign Volume(fl3) 2,912 888 R A NOTES. - BgMoatment toll slxina 1. SEE NNICAL REPORT FOR RECOMMENDED PAVING SECTIONS' 2 1 v p(te)- 2.912 g n TC IS SET 6-ABOVE EXISTING AC. AC CONFORM WORK � REWIRED. _ A�usled LFutBmhS a Uas)- O.fi2 r Z 2 Aesuna saWall hbne a} 02 .b111 -based Ickv wborla TOP OF CURB(TC) 4 Pmim'n o! sTrlwm olmlal sudaca aBeaR AP(f!T•.00a AT 2,252 _ �rO O EXISTINGACPAVING + .._ 5 Asefmm%6meler surfaee 42 ^ ' Vol.Surface Area(ITT) 1275 EXISTINGCE BASEPAC-ROCK 6VoLo/rlmo6fdbring DeoughtreetmeNsoa-VRf2)• XS'Lhrx(1 N12 h)XOuration(Me) 1.647 4 3 AGGREGATE BASE ROCK 7 Portlon a/V1N0 reQtlm 6o 9m h Stored aroo:VP(Kt)=Woo-VR 1.285 r i O O EKISTING COMPACTED SUBGRADE 8 Awm ndhg depth b bal—n 6 and12 h-HP in-W fta/A>R a 12 W9 11.9 w o O DIRECTIONS �)IB-O.C.WBOTH MIltmumm "dblofmatment mYsurface ama R2 1275 0 5 Os REBARSItALL HAVEAMWIMUM a CLEARANCE OF 3-FROM EDGE(TYP) 3UTTER � gg9 ZL 17 O1 SEE LANDSCAPE PLANS FOR PLANTING AND MULCH INFORMATION NATIVE SOIL DO NOT COMPACT 3 2 4-PVC PIPE FROM AREA DRAIN IN TRASH ENCLOSURE.0.5% I 6 SLOPE. 3'TAfq,1. O4 CLEANOUT WITH CAP AT FINISHED GRADE H N '��-f ,.._„�; O OEM BOIL WITH PERCOLATION RATE OF 5 TO 10'PER HOUR(18- S 5 DEPTH).SOIL TO CONFORM TO SOIL SPECIFICATIONS AS LISTED R IN APPENDIX C OF THE C3 STORMWATER HANDBOOK Rfi 7 CLASS II PERMEABLE ROCK PER CALTRANS SPECIFICATIONS(Ir MIN DEPTH). ppoiF NATIVE GRADE OR ENGINEERED FILL .•Ll� �g W l-PLACE COBBLE STONES .%i O ATRIUM GRATE C7224 ' � TO EDGE OF (11� ^• BIO43ETENnON CELL - ! v O9 COBBLE STONE DISSIPATOR.PLACE 4'MIN DIAMETER COBBLES FOR 7 �IF OUTFALL. ,,rn��,ml SECTION B-B: NORTH TRASH ENCLOSUIRE BN ALL IOTRCTIONS DE,gTMENT PPIZO+Ir aNIL PILES STONES •I'L\1�API'Ii11V F.D` 'h'oFCAle1i•' TON CFJl �_J�_-�r�� NTS - 1Ns .n Yw ales-.o bum•.n n>•.a•-+,ern.nl!w rulrofmc^ ro[:nY M Gam rca Srtlo�l fsr'rvnn LMm.Ptin Pan aN:Y U) I '..•.W aHYy-t rt nvl+r4 rvu^nn.�uuJ'ie!bt Fa•n tea tLmYn4 ZO N / r Or:+sYl Wak pefu+ra rwn:w to auS l:m oil fs aonv�n ercmtnu ms N.i and tll'ggcob min.IFb eWm.'Y1 IM b hM[- � m- 1 OBLIQUE VIEW PONOING DEPTH FROM INLET OPENING TO GRADE(11.9-) << K O 9.71' O IMPERMEABLE LINER(30 MIL PVC OR EQUIVALENT)TO EXTEND TO ALL SIDES OF BIOCELL.ADHERE TO CONCRETE CURB PER MANUFACTURER'S RECOMMENDATIONS r C'W(D OR EXTEND LINER OUT AND BURY END PER MANUFACTURER'S RECOMMENDATIONS. 0 CUTCURBAND GUTTER fi 12 6 _ 0 GROUND COVER AND/OR VEGETATION(SEE LANDSCAPE PLANS FOR PLANTING O(-7<m 5 - 5 AND IRRIGATION.)-TOP OF MOUNDS AT LEAST 2-BELOW CREST OVER FLOW RISER Z t O I O NATIVE GRADE OR CERTIFIED COMPACTED SUBGRADE K 0(O•J Z 13 UIQ SEE PLAN FOR SURFACE AND SLOPE Z�O(Jr m� �'�4�'n'.xa•.:Sti; '`� O6 DEEPENED CURB AND GUTTER WITH CURB CUTS,SEE DETAIL 2 ON THIS SHEET ~to �*:,.`° - L't; ,t{r:!,r'-;f;,rY •y,c^.� FORCURBCUTDETAILS.SEE DETAIL 3 ON THIS SHEET FOR DEEPENED CURB AND )_�� w '�', ^:'`,.-.••.•,, GUTTER DETAILS. O W 5 O7 COMPACTED AGGREGATE BASE W - J g BIGRETENTION SOIL MIX CONSISTING OF A SANDY LOAM WITH AN INFILTRATION O +��\4 rJ-k F.:•'r t'-':; r: RATE OF 5-TO 10-PER HOUR(MINIMUM IS-DEPTH).SEE APPENDIX C IN THE L- m SCVURPPP C.3 HANDBOOK FOR MORE INFORMATION.CONTRACTOR TO SUBMIT W COMPLUWCE CERTIFICATION FROM SOILS SUPPLIER PRIOR TO CONSTRUCTION. 2rJ Y';:;;j:" O9 10 PEA GRAVEL(MIN.2-DEPTH) 8 0 11 10 12-MIN OF CLASS 11 PERMEABLE ROCK PER CALTRANS SPECIFICATIONS 'e'e 11 6-PERFORATED PVC SUBDRAIN AT MIN SLOPE OF 0,545(PERF-ALL-AROUND OR 9 STANDARD DRAIN PIPE WITH DRAIN HOLES INSTALLED DOWN). 4rg�g SECTION A-A: BIOTREATMENT CELL(BETWEEN CURS ,2 6'PVC OVERFLOW PIPE WITH NDS H90 POLYOLEFIN ATRIUM GRATE.(SEESHEET2.2 3 NTS FOR OVERFLOW LOCATIONS.)CONNECT OVERFLOW TO STORMORAIN SYSTEM. >7 1J COBBLE STONE DISSIPATOR INSTALLED 4'MIN DIAMETER COBBLE ALONG EDGE SCALE: OF BIORETENTION CELL.AT CURB CUTS INSTALL 02'BELOW CURB OPENINGS FOR AS SHOW A DISTANCE OF 7 ALONG EITHER SIDE OF OPENINGS. HMH TO CERTIFY THAT CONSTRUCTION WAS BUILT PER PLANS AND MEETS C.3 SHEET: 11 REQUIREMENTS. ' TREATMENT SUMMARY TABLE STORMWATER CALCULATIONS a USING FLOW&VOLUME BASED TREATMENT MEASURES _ 'MFATMCMCONWOL 5UMMAiiY � DRA*IAGE AREA RIIMvYER d1 Ncnv Total Pavementl rtlsfin®pavement 1 ToW DraktW Aron to 1910-Ar0) 56,304 afd'nage aeafedlaeplated alovealtmear Nardstage OffmiArxlfabr S Area ImpetviousAmo Ar¢a&qulred Aare Nof Tfeatedln Net rreatm¢nt knpertleuo Slalaaa Maa 2 Pwcard knporvleusrtass 1%)(55) 56,0 100 phase l'r•I.1 s,, TCMT ¢ fsJ) Treated glafMotment Cells Area 9 Won Amusl Proetp%afbn!n) 14.9 phme5 4 Row gaga cbsosf fo 9w ke•San Jana Arpan AWPgage(„) 13.9 Undeglgnated 23,W7 23,101 - 1,BW YD,B01 -23'sw s Ralti" otfacfwflfaclar 1AY DMA Bf �c,304 0 Blstrddotlmanl 1,Y75 0 50,3t24 6 Bail typo for drakkVo aroa e D(clay) Y Avorago Mopo for lho draktago area(eel%to 10%)(%) 1 g � Bimreatment 5 UNt booln storago from slebtg curves(in) tl.55 YOYAL 56,Y04 0 1,2T5 1,9a0 -23,6a/ 32A9T -a Coll Flom(1S4)a 0.58 D(day) Per SCWaepp C,S Handbook,ADprad/f 0,SR(Vn IV plg D•0(15%)a 0.60 0(c9ay) -m 9 Sim the Ow-Water dualRyCosign Volumo(w3) 2,912 m e Blafrat8m mcall912 ta. OTECHNICAL REPORT FOR RECOMMENDED PAVING DNS. 1 Vya 3ET 6"ABOVE EXISTING AC.NO AC CONFORM WORK RED. Ad)ustad UnH Basw Staraga(uBs) 2 Agsumo rainfallkdansByal 02 tngvfor/knwfrdsad strhg arkerla O TOP OF CURB(TC) 3 Dwatbn of the rain avant(hts)= (UBSIRehdak WOM10 B.1tl 4 ptoliminaryestlmatoa(tsWlsuAseoarea•AP(ftr)=.USxA7 2,2J1 O EXISTINGACPAVING S Amme%smalfor sw/flee 42 Val,Stu(aoo Aroa(IV) 12T5 EXISTING COMPACTED a i O AGGREGATE BASE ROCK 6 Vol.of rlmof/6,YarWg ltvough ifeatrnoM saN•VH(( )=A,%5"011%(1 fU12%I)%Dwatlon(Ws) 1,64Y Y I Fonbn of VWd roq'd to be storad In pondktg area:W(fe)=Wm-Va 11265 m a a OEXISTING COMPACTED SUBGRADE 9 Avaroge tmndwg doplh k bo woom 6 and12(wJ�Hp(wJ=W Ha/M ftt%12 Wl9 11,9 O DI RE AIRDIRECTIONS AT 16"O.C.IN BOTH Mlnlmum re ulrodblot�eatmcnt colleutfaca area(H m DIRECTIONS(TYP) (( 1275 c o 0 OREBAR SHALL HAVE A MINIMUM CLEARANCE OF 3"FROM EDGE(TYP) c E `B o 2U v Z 8.—- �U �E J� N E r8 m8 1O SEE LANDSCAPE PLANS FOR PLANTING AND MULCH INFORMATION o s 9 O2 4 NATIVE SOIL DO NOT COMPACT 5' S' 3 O 4"PVC PIPE FROM AREA DRAIN IN TRASH ENCLOSURE.0.5% o1 6 SLOPE, A CLEANOUT WITH CAP AT FINISHED GRADE o (n'AI fo O BSM SOIL WITH PERCOLATION RATE OF 5"TO 10"PER HOUR(18" $ DEPTH).SOIL TO CONFORM TO SOIL SPECIFICATIONS AS LISTED 0- 6 IN APPENDIX C OF THE C3 STORMWATER HANDBOOK. 7 ©CLASS II PERMEABLE ROCK PER CALTRANS 6 SPECIFICATIONS(12"MIN DEPTH). O7 NATIVE GRADE OR ENGINEERED FILL PLACE COBBLE STONES ,, ( ©ATRIUM GRATE TO EDGE OF MO-RETENTION CELL 2 O9 COBBLE STONE DISSIPATOR.PLACE 4"MIN DIAMETER p COBBLES FOR 2'IN ALL DIRECTIONS OF OUTFALL. �`SECTION B-B: DRY WELL \ /NTS U \J Z N 't O o 1= ^00BLIQUEVIEW UZ a N¢ wLUWWzO2PONDING DEPTH FROM INLET OPENING TO GRADE(11.9') Q Z0- —Q W s 71' O2 IMPERMEABLE LINER(30 MIL PVC OR EQUIVALENT)TO EXTEND TO ALL SIDES OF J U a BIOCELL.ADHERE TO CONCRETE CURB PER MANUFACTURER'S RECOMMENDATIONS lti � OR EXTEND LINER OUT AND BURY END PER MANUFACTURER'S RECOMMENDATIONS. W a Q m 12 0 GROUND COVER AND/OR VEGETATION(SEE LANDSCAPE PLANS FOR PLANTING U CURB AND GUTTER 5 6 6 5 AND IRRIGATION.)-TOP OF MOUNDS AT LEAST 2"BELOW CREST OVER FLOW RISER. -U Z�Q ® NATIVE GRADE OR CERTIFIED COMPACTED SUBGRADE w OU Z 13 _ a 3 O5 SEE PLAN FOR SURFACE AND SLOPE ZO ED m 2 U W H © DEEPENED CURB AND GUTTER WITH CURB CUTS.SEE DETAIL 2 ON THIS SHEET a H U FOR CURB CUT DETAILS.SEE DETAIL 3 ON THIS SHEET FOR DEEPENED CURB AND LU U < GUTTER DETAILS. Q Z O7 COMPACTED AGGREGATE BASE W 6 O BIORETENTION SOIL MIX CONSISTING OF A SANDY LOAM WITH AN INFILTRATION O Q RATE OF 5"TO 10'PER HOUR(MINIMUM 18"DEPTH).SEE APPENDIX C IN THE I- a SCVURPPP C.3 HANDBOOK FOR MORE INFORMATION.CONTRACTOR TO SUBMIT U 9 COMPLIANCE CERTIFICATION FROM SOILS SUPPLIER PRIOR TO CONSTRUCTION. 2 [�9 10 PEA GRAVEL(MIN.2"DEPTH) i y 11 LL 10 12"MIN OF CLASS II PERMEABLE ROCK PER CALTRANS SPECIFICATIONS 4, - Mr$ a 11 8"PERFORATED PVC SUBDRAIN AT MIN SLOPE OF 0.5%(PERF-ALL-AROUND OR STANDARD DRAIN PIPE WITH DRAIN HOLES INSTALLED DOWN), �,1SECTION AA BIOTREATMENT CELL (BETWEEN CURB) n 6"PVC OVERFLOW PIPE WITH NDS490POLYOLEFIN ATRIUM GRATE tSEESHFET22 w� U zQ zQ I e I 1 I 0 I O I N � 0 5 10 20 0 E f EXISTING TRASH ENCLOSURE � . INCH=10 FEET FENCE TO REMAIN rc m 35SOUARE OJ. FOOT DRYWELL 178'S EXISTINGTRAIL TO REMAIN II I m �� G I-1pB BC3.1 OSS CS 24•S 0 U •a 16'-4"PVC SO lH (�S=0.OD5 - EXISTING FIRE HYDRANT TO AREA DRAIN I - --- REMAIN n MATCH TG TO Ex FS rF--w W W W w W W W w,-L4_ J1-W, -yI R INVERT 1.33'BELOW EX FS i' I SEE ARCHITECTURE PLANS FOR TRASH ENCLOSURE DETAILS V m �1 - I o SS 7 o rj rj 3 EXISTING 7 TOWER 1 E _ q 2U N PP J`E 3 yo `o I I rn B 33 I I I I f I JI3 c,l o w w w w w� I ass ss ssss ss ss xsss ss ss— _33 r N N UJ U Z U)Q N 0 � gio 'o 0 J Z 'o 0 W W F OQ0� z w �Ua o W p 2� zc UTILITY NOTES: _ z 0 U z I. SANITARY SEWER LATERALS CONNECTED TO SANITARY SEWER MANHOLES g <Q SHALL BE OS'ABOVE MANHOLE FLOW LINE UNLESS OTHERWISE SPECIFIED. p- Ur DO 2 2. BUILDING SEWER SHALL BE PVC SDR26 UNLESS OTHERWISE SPECIFIED.B• H(n U SANITARY SEWER LATERALS SHALL HAVE A MINIMUM SLOPE OF 2.0%UNLESS q OTHERWISE SPECIFIED. F o Z�S 3. PR � OVIDE IO'MINIMUM SEPARATION BETWEEN BUILDING SANITARY SEWER O AND WATER,WHEN POSSIBLE.MINIMUM VERTICAL CLEARANCE SHALL BE 1.0'. W IF IN THE FIELD,THE VERTICAL SEPARATION BETWEEN SANITARY SEWER& U STORM DRAIN CROSSING IS LESS THAN 12•,A HIGH DENSITY FOAM BLOCK Q' SHALL BE USED BETWEEN PIPES. Q ��/� a 4. ALL PRIVATE ON-SITE STORM DRAINPIPE SMALLER THAT 12"IN DIAMETER SHALL BE PVC SDR35,IF DEPTH IS GREATER THAN T.WITH A MINIMUM SLOPE OF 1%UNLESS OTHERWISE SPECIFIED. Z S. ALL PRIVATE ON-SITE STORM DRAIN PIPE 12'OR LARGER IN DIAMETER SHALL BE PVC SOR35,IF DEPTH IS GREATER THAN 3'3',STORM DRAINPIPE WITH A MINIMUM SLOPE OF 0.5%UNLESS OTHERWISE SPECIFIED. 3 6. JOINT TRENCH DESIGN SHOWN FOR INFORMATION ONLY.SEE PLANS BY RGA 6k:69 r 7. CONTRACTOR TO EXPOSE EXISTINGGRAVITY CONNECTION POINTS AND CHECK INVERTS PRIOR TO THE CONSTRUCTION OF NEWUTILITIES.NOTIFY ..Id - `Ai=�ki� aes V Q 6 o ` so \ ' 10 ®! I 0 25 50 100 I • D 5 of l I 1 INCH=50FEET ogm , p m EXISTING HOTEL „ I I ¢ m e r o w I I I 0 �+DS as }ID BO °SEI ® < h � EXISTING RETAIL t w NORTH I I I LL LEGEND ' o f o - I PROJECT BOUNDARY TREATMENT AREALIMITS wv eso d8 w I BIOTREATMENT CELL DRAINAGE AREA �•.'(' m>> E .:.''. MAINTENANCEAREA �IVI $ _ (NEW PAVEMENT AREA NOT TREATED) a Iwl o� N I I PAVEMENT AREA TO BE TREATED IN 0 I0 BIOTREATMENT CELLS � lll\ tli![� EXISTING RETAIL ®`�`®`— QI I rc� � u SOUTH / — _ DD s e / ICI I IN ARPEAA BEMENT TO BE TREATED o' N \^ EXISTINGRETAIL // FjcpnRKiNc TCM SUMMARY TAB Q DRAINAGE I REQUIRED PROVIDED RISER SD s TCM# IDENTIFIER AREA TREATMENT TREATMENT EIGHT \ Aso SD I r , 1 et 56,304 SQ FT 1,275 SQ FT 1,332 SQ FT 11.9" O TOTAL DRAINAGE 56,304 SQ FT Z U N o • /1/1 I *PER CHAPTER 2.3 OF C3 STORMWATER HANDBOOK REPAIR/MAINTAINCE a J z i J\ I N I I PROJECTS ARE EXEMPT FROM PROVISION C3x OF THE MUNICIPAL d W m~ STORMWATER PERMIT. (� o a Z Q W i — z EXISTING RETAIL I I Q >W SOUTH i 'SD-. - I tw ZOO /PSiKING � c7m< ------------- h - II II mmw� o �5 B 1 so ® ® M I LU II U r I I a EXISTING BANK o , n PROPOSED 11 f EX—ING 1 I I o BK TRFATMENTµ--.ELL fit•=�o.�5-T��zk �' �,ra'aa��:•_. =��",�: r � .«?.�.�.'�M;.yaws...}�� pit ��;� c � }�pa�r;-�.. s 50 50 50 50 s - t • �x� `fe` •ne 1 v Us Y r ry. t S r. ( ` I Irv` F Driveway #6 p e 1 attached Minlrnum Wiper LengEh anti MUTOO fi Ghanrtelizer flevicaspadrr& cAMuren26x4 Speed":S!' MatgwgTapLw Shifting 5h6ulder 136mr Maximum Maxuoum Bascom Ave Single No. : MPLi�' Spcng.Fr T6Oi�.1j2LT TaptVSL'Fr spac6;q mannehrk vuimeozeSite Plan spacing .Spacipg Street MPH: 35 Tavern Tegtg�ritpl ruuenstat�e.. . • , � 10 fo 40 27 Es 20 40 For: Driveway Reconstru .. 125 63 42 200 25 50 WorkingHours: 7am - 5 Mduntalm4low Gfl CSSD)96r8.3828 30 18D 90 5D ZW: 30, 60 K as .245 123 82 250: 55. 70 Contractor Notes: :40 .320 160 1W am 40 8o 1.All traffic control devices shag contorts to the latest edition of California Manual of Uniform Traffic Control Devices .qS �540- 270 180 360:. 45 90 and the Standard S'ejeations for Public Work. 50 600 301i, Zoo A75 50. moo. 2.Flashing beacon(s)will be placed at the location(s)indicated for lane closures during the hours of darkness. - 3.All workers shag be equipped with a reflective vest.All flaggers shag also be equipped with a C28'Stop/Slow" :55 660 ,33Q 220 4,95. No n paddle and shall be trained in the proper fundamentals of flagging traffic. .60. 720 $60 240 SZO 50. 106 4.Any conflicting signs shag be covered for the length of the job. GS 780 390 20 E45 50 10.0 5.Access to residents and businesses shag be maintained at all times unless noted. 70, 840 42q 280 730- 50. 100 6.A safe pedestrian mute wig be maintained at ail times. - - -- -- 7.Lane width will be maintained at 11 foot minimum unless noted otherwise. 7S. 9o0 �450 300 820� so. 100 ,Recommended.;Advan-.Wafning ftn_LSpaejm a.Traffic control personal will accomodate emergency vehicles at all times. �IA,11:11 cA(Mt�rGD2tl14 1000 500' 330 1000 1W 08- 9.'Uneven Pavement Surface°sgns to be Installed at ail lateral milled transitions. N/A 10 -A� NIA $ 610.Engineerhas authority to institute changes to ensure safety. umrmmvaysr�; Distancaf3e1xeet s/aereg - 38 25 NIA -13; 25Road TgpFw- ;4 H tlt ?eL�.rWtp#ftjt"tegJUgmenbfoiwwkmi.8im rrsswarFzad;pce N.�piva�^te Urban-25 mF$i of lest•- logt - 1Dpfl Date: 2/15/2017Author: Brett Hickman Pro°ect: Prune and Construction 121 P"a�"` p`�"�'pkkkfi l sef«�nw ra°«"_ UUn—TpareIhap25 mph,W40Ylnpn• 250if 20tt Comments: 41 ; as „ unman(—ttiorO an4Qmlpph- 35aff =A wwia2A nbemluadNA>Facaieeawa ci 1.nYivagrace,.aeuuveyn+ru oft.a.damm�fi�s'. Ftimal Bob if, 500R fe) ,gurce�aa v6�nnrtaele:imFsc,faub.n+'rei.snovigtnnriee.*ese�vag.:a::endaf*V4acm lif"Of Eic.essw JFre-. 1000ft' i5o06 Plan Sheet Dq(1)fMNKBaE rt•teMLGA4cgpt' SAaeaxVehtcPa.. A"cieEekan,e ».�a5°eeReies:Tartcaora<IeIFS.aiRxaieka6ec 50 _ 50 50 50gj s r • -_ � r Y f k � i 1 t. . t 3 F t r� �.d 6; Ak Ss r: s= b O.Minimu TaerLengthnd Na7imum Channe"zer)evtespacfng:Driveway ri e Y #V per attached r ca nnUTcti 2014 Speed';S" MergingTaper Shifting .Shoulder Buffer Manmliin Maximum Bascom Ave Single No. MPH(j 5pdc7ng:Fr Tapierl/21, TaperV3L F.r Sparel4) Channelkzef :ChanhellYer Site Plan spas& spaclrig Street MPH: 35 Tapefol'. TongertfBi zQ etl 40 27 its 0au For: Driveway Reconstr .25 125. 63 42 i155 .25. 50 Working Hours: 7am — 5 MountednY{�w:CA (850�88616128 30 18Q 9Q 0 700 30, so 35 245 123 82 250, 35 1 70 Contractor Notes: 40 320 160 107 305 40. 80 1.All traffic ccmrol devices shag contorts to the latest edition of California Manual of Uniform Traffic Control Devices 45 S40 270 180 360; 45. 90 and the Standard Specifications for Pu!>rc Work 5o Goo 300. 204 425- 5o, 10a 2.Flashing beacon(s)will be placed at the location(s)Indicated for lane closures during the hours of darkness. 3.All workers shag be equipped with a reflective vest.All flaggers shag also be equipped with a C28'Stoptsw .55 -660 3W 220 495 $0. 100 paddle and shag be trained In the proper fundamentals of flagging tragla .60 720 .360 240 570. So. 100 4.Any conflicting signs shag be covered for the length of the job. SS- 780 :390 264 :645 50 100 S.Access to residents and businesses shag be maintained at all times unless noted. 70 1840 420 280 730 so. 100 _ 6.Asafe pedestrian route ea'U be maintained at all times. '75 900 45Q 300 820 50 100 7.Lane width will be maintained at 11 foot minlmum unless noted otherwise. - _Recommended Advance Warning Sign Spar 8.Traffic control personal wig acccmodute emergency vehicles at all tunes. 1Of�ar`"n' cn MUTGU201$ 8.'Uneven Pavement Sudace•signs to be insta➢ed at all lateral milled transitions. Fleerrepo(t5 itlDtl. 'S00 3301000 1000 48 ,,,.Uneven has authority to Institute changes to ensure safety. e�aeaxrm: NIA la: 8 N/A. 3 6 my g Distance Seluirt Blcgdtt' sc.erQ 38: 25 N/A ,1i- 25 'Boat!Typo 'A 6 dl geJgirc.ipeimcStaie,reluueimm�rorworktd Sra� o5ad;yAa Nr$�wm; Urban'-25 mph of dessk 1QQR 100a Date: 2/15/2017Author: Brett Hickman Pro'ect: Prune and Construction p' "° °"d " d`°e.�u a aadn ,rers°w.� Urbar_More than 25 rmWhx Omph* zSQR 404 �'� s.If S ' 1FIfR wlmi l te idfi Ubn—morg than 4a111 350it it Comments: 50Q9 WO laJ Burr+DAre mava B�bp4ed.I, oedybs4 s� II Idh10Iis a�doanrr:am a ha wane tio111.1 0 R essvr /Fre 1do0ifY 150U8 eeulpmMtlha mntexletteaept} e3hsdwu.YeM1�le., FFsredexsem¢awd<os•.o aa�ava.m. .rcarw.ttt,i - --- -- --- bzr -1-- --- I ... -- .,..:..I. I ...'`_•_1.C-_-.;T•\ -. � M OR TRUCK ROUTE ENTRANCE o f;— SD SD � o I IE� --- f to I ro 0 30 60 120 i I I b I / 1 INCH-60 FEET II L PROTE E-1 IN I I TYPE 5(TYP) C5:5 0 ! 1 I ; QS , ............ Sb- : i . I I i °•' I .:z._.. 1 i -Y El I , SE-5 FIBER ROLL LA 1• i.. is : - I O so ,I I ! •iI I 1 !. , I I { I 17' I -- I I I I I :N .� `�� • I -� � '•o'. � •` ' � j � -..- I I III. _. - i I I -�- -( �,I .. I • T i . � Jv , I 1 SID L A - -- ._. ......._ I ! . I I I i I I o` ICI II , -( I-I- I I III I �iII � i. ! , 1: ,;f� :• :- .: t I � I � - .. nit�b.iw+r.�'li�Iuro}�i«,���L,�����,_�•, vm9 v%plan And ri mi a{tYkab'n s..axle v i I p,. W I,ndrx::':,.:1 a5 to L`C Wl o{'n:cNai l_::.. 1°S —SD - ._ _ ------- - D — — — - -- _-• --- -- - ---------—SD D--^.O apt�K,u���:••0ra1 6 15 5 T -E--MB— LL ---.........-------- .....- FRnSInN ANn gF=n1KIFNT rONTROI KJOTFS nnAIINI-=INIAAIl-C croulcni is c NOTES BASIS OF BEARINGS FOUND 3/4'IRON 1. DISTANCES AND DIMENSIONS ARE SHOWN IN FEET AND DECIMALS THEREOF. THE BEARING WEST OF THE MONUMENT LINE OF EAST CAMPBELL AVENUE FROM UNION CAMPISI WAY PIPE WITH GEAR SPIKE R3 N89'49'S0'W 370.19' (N8948NOW0 370.tY)R3 IN MONUMENT WELL PARCEL. . f!/�e�P 2- THE DISTINCTIVE BORDER DENOTES THE BOUNDARY OF.THE SUBDIVISION. AVENUE TO SOUTH BASCOM AVENUE AS SHOWN ON THAT RECORD OF SURVEY FILED a_ _ _ _ FOR RECORD IN BOOK 244 OF MAPS,PAGE 42, SANTA CLARA COUNTY RECORDS, FOUND 2.5'BRASS R3 3. THE AREA WITHIN THE DISTINCTIVE BORDER IS 27.24 ACRES,MORE OR LESS. AND AS FOUND MONUMENTED, WAS ADOPTED AS THE BASIS OF BEARINGS. DISK WITH PUNCH N00100'12'W 394.96' 4. THE SUBDIVISION IS SUBJECT TO AN EASEMENT FOR EMERGENCY VEHICLE FLUSH IN CONCRETE (NORTH 394.98')R3 ACCESS WAYS AS DESCRIBED IN THE CC&R'S RECORDED IN DOC I THE PRUNEYARD FOUND 2.5'BRASS DISK CONSISTING OF 2 SHEETS WITH PUNCH IN MONUMENT RIDGELEY LANDS OF SAN LANDS OF NORTHVIEW REAL d> LN..-5VIO"W-11209.90, LANDS OF NORTHVIEW REAL LANDS OF NORTHVIEW REAL WELL STAMPED'COUNTY DRIVE BEING A 3 LOT SUBDIVISION OF THE REAL PROPERTY DESCRIBED IN Q OF SANTA CLARA' .• DOCUMENT NO. 2274635Z OFFICIAL RECORDS OF SANTA CLARA COUNTY, JOSE WATER WORKS ESTATE INVESTORS, LLC ESTATE INVESTORS, LLC ESTATE INVESTORS, LLC R2 5332-OR-195 DOC 18060045 N89'S3'10'W 47.00' "� AND LYING NATHIN THE CITY OF CAMPBELL, COUNTY OF SANTA CLARA, U DOC 18060045 DOC 16060045 1 D' 22 a I STATE OF CALIFORNIA. __ �, (D.R7 /@1NLE DOC 233576W 1 .0�------ --- &� -- - 426.43' --r - - -- 2st.83-- - -- TFEBRUARY. 2017 -- h/ I IV PG OREC ESUT ,\\ r-- -------------------- ------- -------------------- .r� 10'SSE 15Z i�@1 11558 I I I SIGN�ALE91r E I \\I I w I I �569-DR-720 I ^^ I to 1570 Oakland Road San J ,CA 95131 I \Jf\I g�g I I __ Jose, o l Y o PARCEL 3 I I N I N 80 0 40 80 E I\I\ k l I p\ n 2.48t AC $ I I I 58 1 INCH= 80 FEET I I N90'00.00"W I I 1I 47 t o 0 60 49.36' RELINQUISHMENT OF I I wl �,I ��/ I I z�� ABUTTEWS RIGHTS N90'00DO'W SEE NAIL B 4043-OR- 06' L6 27. DETAIL AN90D00' NITS 30 0 \JMcBAIN I II II / AVENUE 71.08 23.69' L8 8 R2OI N9WOO'00'E L1 I UNN89'59'51'W 68.35' L10 D 2.5'BRASS NOO'00'00"E _ L. LEGENDKZI 4 ' 23.65' L73 WITH PUNCH 10 SSE WILL BE QUITCLAIMED BY I I I IN MONUMENT WELL DISTINCTVE BOR DER LINEN000000E 5 STAMPED'COUNTY INSTRUMENT TO ACCOMMODATE-I! 8 10• NEW LOT LINEFUTURE BUILDING PHASES �L B OF SANTA CLARA' NTS STREET MONUMENT LINE A ------ EASEMENT LINE $E j PARCEL 1 __---� I I I o I I// �rj I � NO ACCESS RIGHTS TO FREEWAY PER 4043-OR-543 vk I 8.61f AC 1 ---- I F 10'PG&E ELEC ESMT �fy�� 1 m lJ.l Ri RECORD DOCUMENT R7: ROS 244-M-42 R3: ROS 466-M-S gggl_OR_ggg--I Qv� REFERENCES: R2: ROS 247-M-35 R4: PM 508-M-33 N90'00'00'W I I IV PG&E RED ESMT y I Aa 0� I cu'v FOUND 3/4' IRON PIPE WITH PLUG AND TACK IN MONUMENT WELL, 144.82' �-I 8919-OR-205 _ __ _1_ Q' ¢ Z O R$ UNLESS OTHERWISE NOTED n I I I r- 8919-OR-208 [C --- I LU 3/4'MW1FE SET&TAGGED 'LS 8720'OFFSET 1'INTO PROPERTY PG&£ELEC ESMT I I I L ] 9897-OR-14 --� I m ? a LINE NOT DRAJNN5T0 SCALE BLS 8720' W 8E,I 8919-OR-208 I I F------ 15Z 155&158 I ; i^ w l - (R) RADIAL BEARING _ O (T) TOTAL OF DIMENSIONS ALONG THIS LINE OR CURVE N a \\ I I I I I al w (M-M) MONUMENT TO MONUMENT DIMENSIONS U � I \\ 10'PG&E EL£C�-%T I I I I I 3 $ B (...)Ry DIMENSION AS DESCRIBED IN RECORD n�N I \\ 8919-�-205 I I I I I z o & 2 E STOMA DRAIN EASEMENT SSE SANITARY SEWER EASEMENT --- ------ - I I to T� F' WLE WATER LINE EASEMENT PARCEL 2 PUBLIC STREET n E I I I I I I I 15.B5f AC I DEDICATED IN k l I I I I I FEE HE AD REON2V WE 1 =I DOC 14849818 a I I i I 10'8891 OR-888 Przff ELEC T I I CURVE TABLE LINE TABLE I DOC 13498778 I ( w I I I I 17'BUS STOP ESMT nl 73' CURVE RADIUS DELTA LENGTH LINE BEARING, LENGTH I / g L------,� E270-OR-215 I / O I I I �----- ------ El C7 42.00' 4139'41' 30.54' L7 ND'OO'DO'E 6.38' E I z I I I I 1W SSE I I I C2 20.00' 4530'16' 15.88' L2 NO'00'00'E 2.00' l I I I I 1132.155&1158 I I I 3 - L3 N90'00'00'E 8.30' I I I I I 10'PG&E ELEC ESMT I I Pi L4 N90'00'00'E 44.89' g / ----- I I I z - / \ LS NO'00'00'E 5.10' H7sro536'W� \L1,\ I I I I FEWTRELL I 7 I I I I I DRIVE / DENS D I \ Ls N90'00'00•W 4.35' I 240.00' \ \ I I I I m L7 N0100'00'E 13.94' 4i. �032'59eI \ IV PG ELEC ESMT I .. n I I + 1 L8 N90'00'00"W 6.83'. 29:4 96 \ \� R-133I10'PG&E GAS ESMT _1 �� �. I PUBLIC STREET ly I L9 NVCO'QVE 15.90' P335-OR-2069 -IDEDICATED INEH�C � N9D'00'°0"E 115.19A. I I / t 4Y 73' FEE HEREON U L70 N90'00'00'E 3.90' // \ ` - I � / I I 1 0 / L11 ND'00'00•E 13.40'j. 1 PUBLIC STREETo \ \ \\\ � L12 NO'00'00'E 2.28'DEDICATID IN o, \ \ 12'BUS STOP ESMT I II SEE` FL73 N90'00'00'W 11.83' FEE HEREON $ \ \ \\ E270-OR-215 I DETAL.D „ AO.O41 AC \ \ 10'PGlE ELEC ESMT \\ II II >/ C2 ,,y( I \ / L14 NOt00'00'E 7.08' 'E �L3 \ pOC 13405760 \\ + II II N8;'0984Z E�!I �.'C` ��C'y W L15 N90'0°'00'W 3.08'775.96' -- " 1IL E N90T)0'00'E 1227.88'(T)R7 # 156.96' L76 NOt70'00'E 5.51'BASIS OF BEARINGS c 1 \ I�!� I N90'00'00'E m 1 1 N90'00'00'E 1058.64 1D58.71'R7 1058.58'R2 240.00' ow zL� _ 26g.25_L __J • - - - - - ( -) (( (•�-)- N •RI COFC ENG' ( -N' L4zm L3 R7 FOUND GRANITE MON WITH 615.82' �"�1 n 442.82'(442.88')R4 N 294.96' 2 775.96' , 1a Z j CONCRETE NAIL IN MON WELL w EAST CAMPBELL AVENUE UI a w N- a. Ns°ro0'oo•E ZIW 0]W N o a l m EAST \ \ --DETAIL E / D Q Q> oa Z n I^ CAMPBELL -N1S 3s5stoFM02 I mIQ a J AVENUE b 'R2 CUFC EqG SHEET 2 OF 2 SHEETS HMH 3655.10.240 * Attachment 2 ER'S STATEMENT PARCEL MAP,.A P CITY SURNErOR'S STATEMENT OWN THE PRUNEYARD . I HEREBY STATE THAT I HAVE EXAMINED THE HEREON SUBDIVISION MAP AND I AM SATISFIED.THAT WE HEREBY STATE THAT WE ARE THE OWNERS OF OR HAVE SOME RIGHT, TITLE OR INTEREST IN AND CONSISTING OF 2 SHEETS SAID MAP IS TECHNICALLY CORRECT.TO THE REAL PROPERTY INCLUDED WITHIN THE SUBDIVISION SHOWN ON THE MAP; THAT WE ARE THE BEING A 3 LOT SUBDIVISION OF THE REAL PROPERTY DESCRIBED IN ONLY PERSONS WHOSE CONSENT IS NECESSARY TO PASS CLEAR TITLE TO SAID REAL PROPERTY; DOCUMENT-NO. 22746352, OFFICIAL RECORDS OF SANTA CLARA COUNTY, - THAT WE HEREBY CONSENT TO THE MAKING OF SAID MAP'AND SUBDIVISION AS SHOWN WITHIN THE AND LYING WITHIN THE CITY OF CAMPBELL, COUNTY OF CLARA COUNT DATE: DISTINCTIVE BORDER LINE AND ALL DEDICATIONS AND OFFERS OF DEDICATION THEREIN. STATE OF CAMPBCALIFOELL, CYRUS KIANPOUR,LS 7515. EXP. 12-31-17 WE HEREBY OFFER FOR DEDICATION IN FEE SIMPLE TO PUBLIC USE ALL STREETS AND PORTIONS OF CITY OF CAMPBELL, CALIFORNIA STREETS NOT PREVIOUSLY EXISTING AS SHOWN ON THE MAP WITHIN SAID SUBDIVISION AND ALSO FEBRU.ARY. 2017 DEDICATE TO PUBLIC USE EASEMENTS FOR ANY AND ALL PUBLIC USES UNDER, UPON AND OVER SAID STREETS AND SAID PORTIONS THEREOF. � LAND CFEP PRUNEYARD LLC, o os K►Aap�9`f� A DELAWARE LIMITED LIABILITY COMPANY 41f"H- BY. CFEP REGULAR HOLDINGS LLC, 1570 Oakland Road San Jose,CA 95131 A DELAWARE LIMITED LIABILITY COMPANY - - No. 7515 ITS SOLE MEMBER BY. EPL PRUNEYARD LLC, A CALIFORNIA LIMITED LIABILITY COMPANY R ITS ADMINISTRATIVE MANAGER �jf OF CAS\����\ BY:ELLIS PARTNERS LLC A CALIFORNIA LIMITED LIABILITY COMPANY ITS MANAGING MEMBER BY: /j - TRUSTEE'S STATEMENT CITY CLERK'S STATEMENT ES F.ELLS _ AMERICAN SECURITIES COMPANY, AS TRUSTEE UNDER THE DEED OF TRUST RECORDED OCTOBER 21, 1 HEREBY STATE THAT THIS.MAP DESIGNATED AS THE PRUNEYARD PARCEL MAP, CONSISTING OF 2 SHEETS WAS _ MANAGING M 2014. AS DOCUMENT NUMBER 22746353 OFFICIAL RECORDS OF SANTA CLARA COUNTY,ENCUMBERING APPROVED BY THECITY COUNCIL OF THE CITY OF CAMPBELL AT A MEETING OF SAID COUNCIL HELD ON THE THE LAND HEREIN SHOWN, DOES HEREBY CONSENT ON BEHALF OF THE BENEFICIARY TO THE DAY OF 20 • AND THAT SAID COUNCIL DID ACCEPT THE DEDICATION OF ALL STREETS AND PREPARATION AND FILING OF THIS MAP. PRTTONS THEREOF OFFERED FOR DEDICATION AS SHOWN ON SAID MAP WITHIN SAID SUBDIVISION IN CONFORMITY WITH THE TERMS OF THE OFFER OF DEDICATION. AMERICAN SECURITIES COMPANY A CALIFORNIA CORPORATION I ALSO HEREBY STATE,THAT THE CITY COUNCIL ACCEPTED, ON BEHALF OF THE PUBLIC, THE ABANDONMENT OF THE FOLLOWING PURSUANT TO SECTION 66434(G)OF THE SUBDIVISION MAP ACT,UPON THE FILING OF THIS MAP: STREET EASEMENTS GRANTED TO THE CITY OF CAMPBELL AND DESCRIBED IN THAT CERTAIN DOCUMENT NAME: ENTICIALRE"GRANT DEED OF SFOR PUBLIC OOUNTY.D"RECORDED OCTOBER 25. 1996 IN DOCUMENT NO.13496778, OFFTITLE: yri�?ttgtcL(n3S WENDY WOOD, CITY CLERK OF THE CITY OF CAMPBELL,CALIFORNIA OWNER'S ACKNOWLEDGMENT TRUSTEE'S ACKNOWLEDGMENT A NOTARY PUBLIC OR OTHER OFFICER COMPLETING THIS CERIIFlCATE VERIFIES ONLY THE A NOTARY PUBLIC OR OTHER OFFICER COMPLETING THIS CERTIFICATE VERIFIES ONLY THE DATE: BY: IDENTITY OF THE INDIVIDUAL WHO SIGNED THE DOCUMENT TO WHICH THIS CERTIFICATE IS IDENTITY OF THE INDIVIDUAL WHO SIGNED THE DOCUMENT TO WHICH THIS CERTIFICATE IS WENDY WOOD, CITY CLERK ATTACHED.AND NOT THE TRUTHFULNESS,ACCURACY OR VALIDITY OF THAT DOCUMENT. ATTACHED,AND NOT THE TRUTHFULNESS,ACCURACY,OR VALIDITY OF THAT DOCUMENT. STATE OF r_P L1fep"%A - STATE OF ALAF0 f 0'A . COUNTY OF � AaGISC� ,^SS •, COUNTY OF SFI FF11f3 A*C0 Ss �"""� . ON FE3RUA1tY Zd 2OLl- BEFORE ME,SNAw1a a-CN IEIS1i 1%INO NOTARY PUBLIC, ON FE69AX& 1 -Ly 20�. BEFORE ME, A•CN IMSTIwW NOTARY PUBLIC, PERSONALLY APPEARED jAftw-S F. F—Lu5 PERSONALLY APPEARED was WHO PROVED TO ME ON THE BASIS OF SATISFACTORY EVIDENCE TO BE THE PERSON(S)WHOSE NAME(S)IS/ARE WHO PROVED TO ME ON THE BASIS OF SATISFACTORY EVIDENCE TO BE THE PERSON(S)WHOSE NAME(5)IS/ARE SUBSCRIBED TO THE WITHIN INSTRUMENT AND ACKNOWLEDGED TO ME THAT HE/SHE/THEY EXECUTED THE SAME IN SUBSCRIBED TO THE WITHIN INSTRUMENT AND ACKNOWLEDGED TO ME THAT HE/SHE/THEY EXECUTED THE SAME IN HIS/HER/THEIR AUTHORIZED CAPACIIY(IES),AND THAT.BY HIS/HER/THEIR SIGNATURE(S)ON THE INSTRUMENT THE HIS/HER/THEIR AUTHORIZED CAPACITY(IES), AND THAT BY HIS/HER/THEIR SIGNATURE(S)ON THE INSTRUMENT THE PERSON(S),OR THE ENTITY UPON BEHALF OF WHICH THE PERSON(S) ACTED, EXECUTED THE INSTRUMENT. PERSON(S), OR THE ENTITY UPON BEHALF OF WHICH THE PERSON(S) ACTED, EXECUTED THE INSTRUMENT. - CITY'ENGINEER'S STATEMENT I HEREBY STATE THAT HAVE EXAMINED THE HEREON PARCEL MAP; THAT THE SUBDIVISION AS SHOWN HEREON IS I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING I CERTIFY UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF CALIFORNIA THAT THE FOREGOING SUBSTANTIALLY THE SAME AS IT APPEARED ON THE TENTATIVE MAP, IF ANY, AND ANY APPROVED ALTERATIONS PARAGRAPH IS TRUE AND CORRECT. PARAGRAPH IS TRUE AND CORRECT. THEREOF;"THAT ALL PROVISIONS OF THE SUBDIVISION MAP ACT,AS AMENDED, AND OF ANY LOCAL ORDINANCE APPLICABLE AT THE TIME OF APPROVAL OF THE TENTATIVE MAP, IF REQUIRED,HAVE BEEN COMPLIED WITH. WITNESS MY HAND. � /�A• � WITNESS MY HAND. NOTARYS SIGNATURE ( ate NOTARY'S SIGNATURE ` +I�^L�L�/J7/mil DATE: AMY PRINTED NOTARY'S NAME SKAT�IF,A•GuR•ISYMAa1 A_CN IZIf'f^r1 Aa C CLAY. ITY OFCA 9 30-17 PRINTED NOTARY'S NAME MPBELL, CALIFORNIA "� �J. COUNTY OF NOTARYS PRINCIPAL PLACE OF BUSINESS 51%13 G1SGo COUNTY OF NOTARY'S PRINCIPAL PLACE OF BUSINESS bw Fitl�"Asw OfF:5S10 NOTARY'S COMMISSION NUMBER 2g(p21q NOTARY'S COMMISSION NUMBER 52 - b{,.zig52 QR1 � _ EXPIRATION OF NOTARY'S COMMISSION YrLAI��W 30 Abt8 EXPIRATION OF NOTARY'S COMMISSION---------------- - - - MAtR.CA1 3OTZOf,A �� � OC�P`nyc3 W m SHAWN A.CHRISTWN No.C 61922 Cow"Ilm 0 2062952 Commission A.-CHRISTEIAN iw"my pu •Ca mornW g Commission i 2D62952 . Say kantim CoentT r NotitT Public•Ci itornia 0 6ilYtCM 802018r SulF"=IstoCounry CIV1\ MY Coma. an.Mar 3D 2018 r `�'OF CAl\EO SOILS AND GEOLOGICAL REPORT SURVEYOR'S STATEMENT RECORDER'S STATEMENT A SOILS REPORT ON THIS PROPERTY HAS BEEN PREPARED BY LANGAN TREADWELL ROLLO, DATED THIS MAP WAS PREPARED BY ME OR UNDER MY DIRECTION AND IS BASED UPON A FIELD SURVEY.MADE IN JUNE 24.2016. A CRY OF WHICH HAS BEEN FILED WITH THE CITY OF CAMPBELL CONFORMANCE PITH THE REQUIREMENTS OF THE SUBDIVISION MAP ACT AND LOCAL ORDINANCE AT THE REQUEST FILE NO. FEE t PAID.ACCEPTED FOR RECORD AND FILED THIS OF EWS PARTNERS,LLC-ON NOVEMBER, 2016. 1 HEREBY STATE THAT ALL THE MONUMENTS ARE OF THE CHARACTER AND OCCUPY THE POSITIONS INDICATED OR THAT THEY WILL BE SET IN THOSE POSITIONS ON OR DAY OF 20 AT M. BEFORE FEBRUARY 2020. AND THAT THE MONUMENTS ARE, OR WILL BE, SUFFICIENT TO ENABLE THE SURVEY TO BE RETRACED. AND THAT THIS PARCEL MAP SUBSTANTIALLY CONFORMS TO THE APPROVED OR CONDITIONALLY IN BOOK OF MAPS, AT PAGES SANTA CLARA COUNTY RECORDS APPROVED TENTATIVE MAP. IF ANY. f y�0 LAND Svc AT THE REQUEST OF NTY DATE: 2,2 17 �J croR�F`�� SANITA NA CLARA COUNTY,CAUFORNRECORDER TTRACY . GIO TTI, LS 8720 �_ * IA No. 8720 BY: . J'l9le DEPUTY OF AL1f0�?�Q 3sssioFMo1 SHEET 1 OF 2 SHEETS HMH 3655.10.240 CONTRACTOR AGREES THAT I SHALL ABB��iL�I��P �� RESPONSIBILITY R JOB �IT���I��� � THE ���B� CCONSTRUCTION OF THIS PROJECT, INCLUDING SAFETY OF ALL PERSONS AND PROPERTY, THAT THIS REQUIREMENT SHALL AMPLY CONTINUOUSLY AND NOT BE LIMITED TO NORMAL WORKING HOURS; AND THAT THE CONTRACTOR SHALL DEFEND, INDEMNIFY AND HOLD THE OWNER AND THE ENGINEER HARMLESS FROM ANY AND ALL LIABILITY, REAL OR ALLEGED, IN CONNECTION WITH THE PERFORMANCE OF WORK ON THIS PROJECT, EXCEPTING FOR LIABILITY ARISING FROM TIME SOLE NEGLIGENCE OF TIME OWNER OR THE ENGINEER. m m c ITT m " < 0 Z �t � - m 0 r - G3 eta --t - -0 ;a � l Z - - 0 -' � - ' 0 � me i c - c � - c r z �u 0 "I°I axonTom 0 m 0 Q 0 oc)0 od z _ M FOR JOB `E CONDITIONSDURINGi COURSE OCONSTRUCTION THIS PROJECT, 1 UDI iT`F+.�T'� AGREESTHAT F SHALL � :� � ��'LE..T' RESPONSIBILITY SAFETY O ALL PERSONS AND PROPERTY; THAT THIS i IREMEN f` SHALL APPLY CONTINUOUSLY AND NOT BE LIMITED TO NORMAL WORKING HOURS, AND THAT THE CONTRACTOR SHALL DEFEND, INDEMNIFY AND HOLD THE OWNER AND THE ENGINEER HARMLESS FROM ANY AND ALL LIABILITY, REAL OR ALLEGED, IN CONNECTIONWITH THE PERFORMANCEWORD ON THIS PROJECT, EXCEPTING FOR LIABILITY ARISING FROM THE SOLE NEGLIGENCE OF THE OWNER OR THE ENGINEER. tv to ,,, € 0 " ci 0 �"-"a m Iry ISS OF m ° �'" tv cixs Tyw. { f tV sn` _ �""` a '1 aw* v ... ' co as is +-3^ rill.3 .. .._a . _._.. . , c to tj tv to 1z CONTRACTOR COMPLETERESPONSIBILITYFOR JOBSITE' CONDITIONSDURING THE OUR E OF CONSTRUCTION OTHISPROJECT, INCLUDING ALL RAND PROPERTY; THAT THISREQUIREMENT SHALL APPLYCONTINUOUSLY ,II�°I� II�I��Ii�4„ WORKING HOURS; AN THAT THE NTRCIaH.Ir DEFEND, INDEMNIFY AND HOLD THE OWNER AND THE ENGINEER HARMLESS- ANY AND ALL LIABILITY, REAL OR ALLEGED, II CONNECTION �� THE PERFORMANCE ANOF K i III III I OPINION I I jqjw ON THIS PROJECT, EXCEPTING OR LIABILITY ARISING FROM THE SOLENEGLIGENCE -OF THE ��IR T�� ENGINEER, CONTRACTOR AGREES THAT HE SHALL ASSUME SOLE AND COMPLETE RESPONSIBILITY FOR JOB IT CONDITIONS DURING THE COURSE OF CONSTRUCTIONR 3 E "F INCLUDING SAFETY OF ALL PERSONS AND PROPERTY; TY; THAT THIS REQUIREMENT SHALL APPLY CONTINUOUSLY AND NOT BE LIMITED TO NORMAL WORKING HOURS; AND THAT THE CONTRACTOR SHALL DEFEND, INDEMNIFY AND EKED THE OWNER AND THE ENGINEER HARMLESS FROM ANY .AND ALL LIABILITY, REAL OR ALLEGED, IN CONNECTION WITH THE PERFORMANCE OF WORK ON THIS PROJECT, EXCEPTING FOR LIABILITY ARISING FROM THE SOLE NEGLIGENCE CE THE OWNER OR THE ENGINEER. I� 5a sr I��rz mx=o • m x fCfD�� V DURING H � COURSE CONSTRUCTION THIS PROJECT, Mkt CONTRACTOR ARE�"i�` ILL MSOLE AND E�IPLE"I"E RESPONSIBILITY R B [�"CONDITIONS OR SAFETYING OF ALL PERSONS D PROPERTY; THAT `T'If REQUIREMENT . SHALL E�RL%� CONTINUOUSLY [+ IT BELIMITED£�RIIa WORKING IdIR D THAT `�" CONTRACTOR HARMLESSSHALL DEFEND, INDEMNIFY AND HOLD THE OWNER AND THE ENGINEER FROM ANY AND ALL LIABILITY, REAL OR ALLEGED; IN CONNECTION WITH THE PERFORMANCE OF WORK ON THIS PROJECT, EXCEPTING FOR LIABILITY ARISING FROM THE SOLE NEGLIGENCE OF THE `NER OR_" ENGINEER.